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Over 1 million rhinoplasties are performed worldwide each year. While autologous cartilage remains the gold standard for implantable material, controversy exists regarding the role of alloplastic implants and alleged risks of infection and extrusion (Loyo M, Ishii LE. Safety of alloplastic materials in rhinoplasty. JAMA Facial Plast Surg 2013;15:162–163). Some experts avoid alloplastic implants altogether, fearing complications in unforgiving anatomy. In other areas of the world, however, they are used widely and successfully. The aim of this study is to summarize available evidence about the safety of alloplastic materials in rhinoplasty.
The cumulative available data suggest that complication rates of alloplastic implants are similar to those seen with autologous costal cartilage and may be acceptable in select patient populations. Careful preoperative counseling with patients about the severity of potential complications associated with alloplastic implants is warranted. Among alloplastic implants, expanded polytetrafluoroethylene shows promise when used for augmentation to the upper two thirds of the nose. Future prospective studies, with defined control groups and standardized long-term follow-up, are needed before reaching a consensus on the safety of alloplastic implants in rhinoplasty.