Expanded polytetrafluoroethylene (Gore-Tex) augmentation of deep nasolabial creases

Objective: To evaluate the safety and efficacy of expanded polytetrafluoroethylene (PTFE) (Gore;Tex; W. L. Gore & Associates, Flagstaff, Ariz) for augmentation of deep nasolabial creases. Design: Retrospective chart review with a minimum of IZ months of follow-up. Setting: Private practice ambulatory surgery center. Study Population: One hundred consecutive patients (average age, 49 years) undergoing expanded PTFE augmentation of the nasolabial crease. Main Outcome Measures: A standardized, reproducible rating scale assessed preoperative crease severity. Clinical effectiveness was determined by the numerical degree of improvement in crease severity rating after surgery, and by the number of procedures required to achieve the desired aesthetic results. Results: Patients initially had grade 1 (14.5%), grade 2 (54.0%), grade 3 (20.0%), or grade 4 (11.5%) crease severity ratings. On average, patients with grade I creases required 1.17 total augmentation procedures, those with grade 2 required 1.60, those with grade 3 required 1.93, and those with grade 4 required 1.86. On average, with each augmentation, patients with grade I improved 0.61 relative severity points; those with grade 2, 0.85; those with grade 3, 1.29; and those with grade 4, 1.28. Nine patients developed late postoperative sequelae. Four creases (2.0%) displayed an unnatural mounded appearance because of superficial expanded PTFE placement. All 4 creases underwent elective removal of a single superficial PTFE strip, with resultant return of aesthetically correct crease augmentation. Five creases (2.5%) developed implant site infections; in all 5 cases, the involved strips were removed and the infection was resolved with a 10-day course of oral antibiotics; Conclusions: Expanded PTFE augmentation presents a safe, effective method for softening deep nasolabial creases. Patients with more severe creases are likely to show more improvement with each augmentation, but are also more likely to require multiple procedures to achieve the desired aesthetic result.