A Systematic Review Of Nasal Augmentation Implants: ePTFE (Gore-tex) Versus Silicone
Han L. Hoang, MD, Michael Januszyk, MD, PhD, J Brian Boyd, MD.
University of California, Los Angeles, Los Angeles, CA, USA.
PURPOSE: Augmentation rhinoplasty has been one of the most common cosmetic procedures in Asian population. Silicone is the most widely used nasal augmentation material. However, over the past few decades, ePTFE (Gore-tex) became increasingly popular as an alternative. In this study, complications associated with each implant were reviewed.
METHODS: Heuristic searches of Medline, Pubmed, and the Cochrane Library were performed using the keywords "ePTFE", "Gore-tex", "silicone", and "rhinoplasty". The reference lists of these articles were reviewed to further identify relevant articles. Only studies with detailed complication reports were considered. A total of 18 studies were included, 12 with ePTFE and 6 with silicone. Random effects meta-analysis was performed to evaluate the differences in complication rates. RESULTS: Eighteen studies including 7759 patients were analyzed. 88.4% of cases in the silicone group were primary, as compared to 78% in the ePTFE group. Differences in overall complication and infection rates were not found to be statistically significant between the two groups. However, malposition rates were significantly lower in the ePTFE group (2.5% vs 6.4%, p < 0.05). CONCLUSION: Although the gold standard graft material for rhinoplasty remains autologous tissue, implant based rhinoplasty is far more common in Asian populations. Both silicone and ePTFE have been shown to exhibit acceptable risk profiles when used in selective patients for dorsal augmentation. However, given the additional risk of implant malposition associated with silicone implants, as suggested by the findings of this meta-analysis, ePTFE should be strongly considered as a first-line option for implant-based nasal augmentation.
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