Augmentation Rhinoplasty With Expanded Polytetrafluoroethylene and Prevention of Complications

Objective: To optimize the long-term results and reduce complications of augmentation rhinoplasty using expanded polytetrafluoroethylene (e-PTFE). Methods: There are certain key principles. The implant should be shaped to conform to the contour of the underlying nasal structure. It should be formed in a gentle curve, without twisting the implant, to preserve mechanical stability as well as to maintain aesthetic appearance. A strict sterile technique during the procedure and a good aseptic technique in the postoperative period are important to prevent infection. External fixation of the implant helps stabilize it. Results: Based on the above principles, 1700 patients underwent augmentation rhinoplasty with e-PTFE from 1999 to 2009. The criteria evaluated included complications and postoperative results: (1) bleeding volume, (2) postoperative swelling of the nose, and (3) pathologic and aesthetic outcomes. Extrusion of the prosthesis developed in 3% of cases; malposition of the prosthesis in 3%; slight bleeding and swelling in 80%; moderate bleeding and swelling in 18%; severe bleeding and swelling in 2%; and infection in 1%. Ninety-three percent of the patients reported aesthetic satisfaction. Conclusion: In this study, adherence to these operative principles played an important role in reducing complications, in preserving the stability of the position of the prosthesis, and in maintaining the aesthetic contour of the nose.