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Applications Of Alloplastic Materials In Rhinoplasty

Rhinoplasty has shifted its focus in the last 10-15 years from an aggressive reductive surgery to one with a greater emphasis on nasal augmentation. As a consequence of this, the need has arisen to have in the nasal plastic with support materials, filling and camouflage. There are several types of grafts and alloplastics available for surgical use today, and their choice depends on multiple factors 1-3.

The grafts can be divided into two broad categories, the autografts, which are derived from the patient himself and include cartilage, bone, fascia and dermis; and homografts, which are derived from tissues donated by members of the same species, and include irradiated cartilage and acellular dermis. Autologous grafts have high blood compatibility and a low risk of infection and extrusion compared to homologous and alloplastic grafts. They remain by far preferred materials in rlnoplastía by most surgeons 45. However, its advantages must be compared with the consequent morbidity of the donor site, availability of the graft and its reabsorption. On the other hand, in malformed noses and, mainly, in secondary rhinoplasties, it is common to find a shortage of grafts necessary for adequate reconstruction 1-5. Some of these techniques are used by Florida rhinoplasty specialists.

Homolngrafts are materials obtained from members of the same species. They include Irradiated cartilage and cadaveric acellular dermis. Irradiated cartilage is obtained from cadaver donor ribs, who are screened for HIV, hepatitis B, venereal diseases, and tuberculosis. Being subsequently irradiated with gamma rays at doses of 30,000 to 60,000 Gy. Due to the absence of cellularity, they are non-immunogenic and well-tolerated by the host. However, one of its main disadvantages is reabsorption, close to 10%. Infection, graft displacement and extrusion rates are acceptable, generally less than 5%. The acellular dermis is obtained from a cadaveric donor and is later frozen dry. It lacks antigens of the major complex of histocompatibility type I and II, so it is highly biocompatible. It is used for the correction and camouflage of Irregularities of the nasal dorsum1.

Alloplastic materials are synthetic, block-compatible polymers developed for use in surgery. In recent years its use in rhinoplasty has been introduced, which is why we consider that its properties and applications should be known by professionals who are related to this surgery. The objective of this review is to show the different types of alloplastic materials currently used in rhinoplasty, analyzing their specific uses, properties, advantages and disadvantages.