Biomechanical and biological advantages of retaining the silicone-induced capsule for cartilage graft survival in revision rhinoplasty

To answer the increased demand for augmentation rhinoplasty, particularly in Asian demographics, a shift from autogenous materials to synthetic implants like silicone and expanded polytetrafluoroethylene has been witnessed. These materials present an increased risk of complications like infection, extrusion, capsular contracture, and dissatisfaction. This study focuses on a case of revision rhinoplasty in a 48-year-old patient with a previous silicone implant and propose an innovative approach in managing the implant capsule. The use of the existing capsule as a mechanical and biological support structure for the diced cartilage graft in dorsal reconstruction showcases a promising method to mitigate risks and improve outcomes in revision surgeries. The capsule around the silicone is biologically active and provides a good environment for the cartilage graft to survive and improve the healing process. This approach tends to minimize the dissection to avoid potential revision complications like skin necrosis, fibrotic tissue, and infections. (c) 2024 The Authors. Published by Elsevier Masson SAS.