Clinical Application of Three-Dimensionally Printed Biomaterial Polycaprolactone (PCL) in Augmentation Rhinoplasty

Overview

Synthetic nasal implants carry infection and rejection risks, while the patient's own cartilage requires a harvest site. This study tested a third option: a 3D-printed mesh made from a material the body gradually breaks down, intended to act as a scaffold that tissue grows into.

Sections of note

• Retrospective review of 101 patients receiving primary or secondary rhinoplasty with a polycaprolactone mesh.
• Clinical efficacy and safety were evaluated with the Global Aesthetic Improvement Scale at 18 months after surgery.
• 98.0 percent showed no postoperative infection-related foreign body reaction or distinct abnormal reaction.
• Implants maintained long-term efficacy through the 18-month follow-up.
• In patients who received spreader grafts, Cottle sign scores differed significantly between before and after surgery.
• Biopsy specimens were obtained from two revision cases; histopathology at 20 months showed adjacent tissue infiltrating the mesh pores plus regeneration of new cartilage-like tissue and collagen around it.
• The authors propose it as an alternative to non-absorbable materials for spreader and septal extension grafts. Level of evidence IV.

What it means for a patient

• The mesh is designed to dissolve while tissue grows through it, so what remains is the patient's own tissue rather than a permanent implant.
• Volume was maintained through 18 months, and tissue ingrowth was confirmed on biopsy in two cases.
• Limits: 101 patients, retrospective, single center, no comparison group, and follow-up of 18 to 20 months.
• Biopsy evidence comes from only two patients, both of whom needed revision.

Why this paper matters

Absorbable scaffolds would remove the trade-off between implant complications and donor site morbidity, and this reports both clinical and tissue-level findings. The histology showing new cartilage-like tissue is the notable part. Follow-up of under two years is short for judging whether volume holds once the scaffold has fully dissolved.

Terms

• Polycaprolactone: A synthetic polymer that the body slowly breaks down.
• Bioabsorbable scaffold: An implant designed to dissolve while tissue grows into its structure.
• Foreign body reaction: The inflammation the body mounts against implanted material.
• Histopathological analysis: Examination of tissue under a microscope.
• Cottle sign: A bedside test where pulling the cheek outward reveals nasal valve collapse.