Rhinoplasty, also known as nose job, is becoming more and more common with personalities and celebrities. The procedure involves correcting and/or reconstructing the form of the nose. Aims of the procedure may include restoring lost functions or aesthetically improving the nose. Various concerns can be addressed using the procedure from length or shape of the nose to size of nostrils.
For this procedure, nasal implants are usually used, but it also likely for some patients to make use of all natural grafts. Synthetic nasal implants are made up of a material that is synthetic and biocompatible. These synthetic implants can be made from porous and high-density polyethylene. Among the commonly used synthetic nasal implants are silicones, Gor-tex, or Medpor. Natural “grafts” are biological materials that went through an FDA approved process, and these can be derived from rib, ear, or septum cartilages.
While there are certain advantages to making use of natural grafts for nasal implants, there are also possibilities that they absorb or even deteriorate over time. These natural grafts can sometimes warp or twist over time. Surgeons make use of both types of implants, and sometimes even a combination of both to be able to get the best possible outcome proving maximum definition and support.
Complications in the use of synthetic materials are also possible. In a recent study, about one out of five rhinoplasty surgeries that made use of Medpor resulted to infections. In majority of those cases, the implant started to poke out of the patients’ surgical wounds. These results startled and alarmed plastic surgeons, especially those who facilitated the study.
Surgeons from the Oregon Health and Sciences University in Portland, conducted the said study, and it said that so far, it is the largest one of its kind. Dr. Andrew Wrinkler, who is also a surgeon at the University of Colorado, headed the study. In the process, the surgeons went through records of 659 patients, those which had rhinoplasty for either reconstructive or cosmetic purposes. Medpor or Gore-Tex was the implant utilized in 151 cases while the rest were donned without the use of synthetic implants.
Based on the study, which is published in the Archives of Facial Plastic Surgery, a total of 19 infections were present, and all of which occurred in cases where plastic implants were used. In all cases, except for one, the implant protruded through the patients’ skin. Nose jobs that made use of common synthetic nasal implants have resulted to higher rates of complication prior to former knowledge. In addition, when these artificial implants are infected, simply prescribing antibiotics will not be enough. Instead, another surgery will be required to take out the implants.
Porex Technologies, the company that manufactures Medpor, has yet to comment or respond to any inquiries made regarding the results of the conducted study.
In contrast, no significant complications were observed in cases where grafted tissues were used in the reconstructive procedures. Wrinkler suggested that the use of grafted tissue from the patient can be the best option; however it is not always practical. The results of the study also suggested that the use of Gore-Tex is quite safe. However, Medpor and Gore-Tex are used for varying purposes, and thus, it is not possible to interchange them or use one to replace another.
Another surgeon who was not part of the study, Dr. Jeffrey Spiegel, of Boston Medical Center, also said that the resulting infection rate was higher than what he would’ve expected. He also said that the use of the patient’s very own cartilage is usually possible, though it takes a longer procedure time as compared to use of plastic implants. It may have its risks and complications, but it’s minimal.
A different expert, Dr. Thomas Romo of Lenox Hill Hospital in New York City, argued that the study overestimated the complications from the nose surgeries. He said that they counted revision surgeries, where the nose tissue already incurred damages and already at risk of infection. He also said that in his experience of almost 21 years, the use of Medpor has a very low risk of infection for first-time rhinoplasty patients. However, after Dr. Winkler and his team considered revision surgery cases, the results still showed that there is a high risk of infection for patients with plastic implants, specifically Medpor.
For any cosmetic surgery, it is always important to discuss the pros and cons with your surgeon. It is essential that you are familiar with the risks associated with your desired procedure before stepping into the operating room. Both aesthetic and functional benefits can result from cosmetic surgeries; it can help boost a patient’s self-esteem and confidence. However, it is imperative that the patient’s safety is always of highest priority.