A Systematic Analysis Between Silicone Implant And Gore-Tex In Augment Rhinoplasty Surgery

【Background】Augmentation rhinoplasty is a term that refers to a set of rhinoplasty techniques which can improve nasal aesthetic results with implant materials[1]. Conventional wisdom regarding the autogenous tissues (e.g., cartilage, bone, dermis/fat grafts) as the optimum augmentation material, because their biocompatibility, safety and are more readily incorporated into the recipient site. However, the use of autogenous tissue is accompanied by donor-site morbidity (e.g., pneumothorax from rib harvest), additional pain, longer operative times, insufficiency of donor-site tissues, and the potential for contour change over time.[2,22].The use of alloplastic implants for nasal surgery dates back to the early nineteenth century, when implants of gold were used for correction of nasal deformities.[3] Over the years, surgeons have used a number of other materials that are no longer considered suitable for nasal reconstruction, including ivory, paraffin, celluloid, glass, cobalt, and cork[4]. And still porous high-density polyethylene (Medpor). silicone implant, expanded polytetrafluoroethylene (Gore-Tex) and so on. Silicone implants (formed from the polymerization of silica (SiO2)) and expanded polytetrafluoroethylene (Gore-Tex) are two of the most widely used implant materials currently.【Purpose】Make a systematically analysis between silicone implants and Gore-Tex in augmentation rhinoplasty surgery. 【Method】First, the authors systematically reviewed the available literature on implant materials used in rhinoplastic surgery by searching the MEDLINE database (from 1966 through September of 2010). Bibliographies from retrieved articles were searched for additional references. All data were independently extracted by two coauthors. Second, the authors performed a meta-analysis of the two most commonly used implant types.【Result】In our meta-analysis, the extrusion rate for silicone implants was 3.9 percent while no extrusion cases reported for Gore-Tex (p=1.97e-08). There is no significantly difference between the infection rate of silicone implants (2.3 percent) and Gore-Tex (1.8 percent), p=0.72. The removal rate for Gore-Tex was 3.9 percent, whereas the removal rate for silicone implants was significantly higher at 6.0 percent(p=0.003).[Conclusion] Silicone implants and Gore-Tex both has their advantages and disadvantages. Future studies are needed to better define specific guidelines for the use of the two materials. Individual has characteristic decision. Newer alloplastic materials are need to be constantly being developed and tested.