The use of Integra™ in rhinoplasty

Overview

Surgeons build up a low nasal bridge with the patient's own cartilage or with manufactured implants. Both can shrink, become visible at the edges, shift, or provoke a reaction. The author proposes a third option: a dermal regeneration template made of collagen and glycosaminoglycans, which the body replaces with its own tissue. The abstract describes the material, how it is handled, and the author's series.

Sections of note

• 56 operations for a range of indications; 30 patients followed for a minimum of 12 months.
• The template is a porous sheet of collagen fibers and glycosaminoglycans with a silicone backing.
• After the silicone layer is peeled off, the sheet is folded over itself until the desired thickness is reached.
• The scaffold is described as fully reabsorbed and replaced by the patient's own dermis.
• The author reports that volume stayed stable over time and that overcorrection was not needed.
• The abstract gives no complication rate, no revision count and no measured change in dorsal height.

What it means for a patient

• This is a filler for the bridge that turns into living tissue rather than staying as a foreign body.
• The evidence is one surgeon's experience without a comparison group; only 30 of 56 patients had a year of follow-up.
• The abstract reports no counts of problems, so the safety profile cannot be judged from it.

Why this paper matters

It is an early report of a tissue-engineering scaffold used as a nasal dorsal filler, an alternative to cartilage grafts and silicone implants. Whether the result holds beyond one year, and how it compares with cartilage, remains unanswered.

Terms

• Augmentation rhinoplasty: surgery that adds height or volume to the nose, usually the bridge.
• Nasal dorsum: the bridge of the nose, from between the eyes to the tip.
• Dermal regeneration template: a manufactured collagen scaffold that the body's cells grow into and replace.
• Glycosaminoglycans: long sugar molecules found in connective tissue; here they form part of the scaffold.
• Autologous: taken from the patient's own body.
• Resorption: the body breaking down and absorbing a graft or implant, causing it to shrink.