Aesthetic and Functional Restoration Using Dorsal Saddle Shaped Medpor Implant in Secondary Rhinoplasty

Abstract

Functional disorders due to alar valve collapse and cosmetic unsatisfactory results can be seen after rhinoplasty operation in some patients. Because of overresection of the upper and lower lateral cartilages, nasal lateral walls may collapse during inspiration pressing against the septum and obstructing airway. On the other hand, overresection may result in several cosmetic deformities. Fourteen patients presenting with nasal deformation and functional insufficiency, were treated using thin sheet porous polyethylene (Medpor). Cottle sign was positive in all patients. On examination, collapse during inspiration, depression at the supratip area, and asymmetry were common findings. Saddle shaped implants, 1.2 × 40 mm in dimension, were introduced into pouches prepared via bilateral rim incision. After suturing incisions, bandage and cast were applied. In the mean 14-month follow-up period, 1 implant malposition was seen in a patient because of larger planning the pocket that was corrected by a subsequent shaving of the implant. Asymmetries of the noses were totally corrected. No exposition was found. Alar collapse and respiration impairment had disappeared in all patients. Although, autologous tissue is known as the best material, Medpor can be used safely regarding its low complication rate because of its porotic architecture and low morbidity in donors. Medpor implant provides functional improvement by its strength body. Its smooth surface helps to correct the asymmetry by filling the defects. Using a saddle shape enabled us to treat different components of the postrhinoplasty deformity with a single implant.