Aesthetic and functional restoration using dorsal saddle-shaped medpor implant in secondary rhinoplasty

Abstract

Functional disorders due to alar valve collapse and cosmetic unsatisfactory results can be seen following rhinoplasty operation in some patients. Because of overresection of the upper and lower lateral cartilages, nasal lateral walls may collapse during inspiration, pressing against the septum and obstructing airway. On the other hand, overresection may result in several cosmetic deformities. On examination, collapse during inspiration, depression at the supratip area, and asymmetry are common findings. Cottle sign is positive in most of the patients. These patients presenting with nasal deformation and functional insufficiency can be treated using thin sheet porous polyethylene (Medpor). In the mean 48-month follow-up period, one implant malposition was seen in a patient because of the larger planning pocket that was corrected by a subsequent shaving of the implant. Asymmetries of the noses were totally corrected. No exposition was found. Alar collapse and respiration impairment disappeared in all patients. Although autologous tissue is known as the best material, Medpor can be used safely regarding its low complication rate because of its porotic architecture and low morbidity in donors. Medpor implant provides functional improvement by its body strength. Its smooth surface helps to correct the asymmetry by filling the defects. Using a saddle shape enabled us to treat different components of the postrhinoplasty deformity with a single implant.