Nasal measurements in Asians and high-density porous polyethylene implants in rhinoplasty

Overview

The Asian nose typically has a low bridge, a short columella and a soft tip that needs strong support to lengthen. Septal cartilage is often too small for the job. The authors measured the noses of average Chinese people and of patients seeking surgery to define goals, and describe using a synthetic porous polyethylene strut in place of cartilage.

Sections of note

• Six measures: tip projection, alar-tip-columellar base angle, alar-columellar base-philtrum angle, nasolabial angle, nasofacial angle and tip angle.
• 100 average Chinese adults (50 men, 50 women) compared with 36 preoperative Chinese patients (13 men, 23 women).
• Implant: high-density porous polyethylene (Medpor) columellar strut for lengthening, in three designs: single plate, double plate and butterfly shape.
• Open rhinoplasty via transcolumellar incision in 21 patients; closed via marginal incision in 15.
• Prominent changes in all six values after surgery in both sexes; the abstract gives no numeric values, follow-up length or complication counts.

What it means for a patient

• Measured norms from the patient's own population, not Western ideals, are used to set the surgical goal.
• A synthetic strut can give the strong support an Asian tip needs when the patient's own cartilage is scarce, but it is a permanent foreign material.
• The abstract reports no infection or extrusion figures, which are the main concerns with porous polyethylene in the nose.

Why this paper matters

It pairs population-specific measurements with a synthetic alternative to the cartilage strut. Later literature reported extrusion and infection with Medpor in the columella, making long-term safety, not addressed here, the central question.

Terms

• Columellar strut: a rod placed between the tip cartilages to support and lengthen the tip.
• High-density porous polyethylene (Medpor): a rigid synthetic implant with pores that tissue grows into.
• Nasolabial angle: the angle between the columella and the upper lip.
• Nasofacial angle: the angle between the bridge of the nose and the plane of the face.
• Tip projection: how far the tip stands out from the face.
• Marginal incision: a cut along the inside rim of the nostril used in closed rhinoplasty.