Onlay Fascial Grafts to Silicone-Polytetrafluorethylene Composite Implants in Augmentation Rhinoplasty: A Retrospective Study of 241 Cases

Khoo LS, Yen CI, Chang CS, Chen HC, Huang CJ, Hsiao YC.

What this paper says

Comparing 64 patients whose composite nasal implant was covered with a temporal fascia graft against 177 without, overall complications fell from 14.7 to 7.8 percent and redness reactions from 6.2 percent to none.

Overview

Composite implants combining silicone with polytetrafluoroethylene are increasingly used in Asian rhinoplasty, but the authors continued to see displacement, redness and infection over long-term follow-up. This retrospective study reports covering the implant with a fascia graft taken from the temple and compares complication rates.

Sections of note

64 Asian patients had augmentation rhinoplasty with an I-shaped composite implant plus an onlay fascial graft, January 2015 to June 2018, mean follow-up 13.5 months.
Control group: 177 Asian patients with the same composite implant but no fascial graft, treated February 2012 to June 2015, mean follow-up 42.0 months.
Overall complication rate: 7.8 percent with the graft versus 14.7 percent without.
Redness reactions: 0 percent versus 6.2 percent, P .04.
Infection: 1.6 percent versus 1.1 percent.
Implant malposition or deviation: 0 percent versus 4.5 percent.
Harvesting the fascia and fashioning the graft added an average 33 minutes per procedure, with no donor site problems encountered.

What it means for a patient

Wrapping a synthetic implant in the patient's own tissue reduced visible redness and implant movement in this series.
Infection rates were similar between groups, so the benefit was in the other complications.
The added step lengthens the operation by roughly half an hour and requires an incision in the scalp above the ear.
Limits: retrospective, not randomized, groups treated in different periods, and follow-up much shorter in the graft group at 13.5 months versus 42.0 months, which would understate late complications.

Why this paper matters

Synthetic nasal implants remain contested because of late complications, and covering them with autologous tissue is a middle path. The reported reduction in redness reactions is notable. The unequal follow-up periods are the main reason to read the comparison cautiously.

Terms

Composite implant: An implant combining two materials, here silicone and polytetrafluoroethylene.
Polytetrafluoroethylene: A porous synthetic material that tissue can grow into.
Onlay fascial graft: A sheet of fibrous tissue laid over an implant to cover it.
Temporal fascia: The fibrous layer over the muscle at the temple, a common graft source.
Malposition: An implant sitting in the wrong place or shifting from it.

Summary written by rhinoplasty.cc from the abstract, 2026-09-09; not medical advice. The authors' own abstract follows.

From the abstract

“Silicone-polytetrafluoroethylene composite implants are fast gaining popularity in Asian rhinoplasty. Nonetheless, implant displacement, erythematous reactions, and infections still occur in the authors' patient group during long-term follow-up. Objectives: The authors reported successful experience of combining the…”

Excerpt; the full abstract is on PubMed.