Polycaprolactone Mesh for Asian Rhinoplasty: Outcomes and Complications of Composite Septal Extension Graft Compared to Mesh-Only Graft

Hyun S, Cho SW, Baek RM.

PubMed 34161991 Publisher (DOI)

What this paper says

Across 774 Korean septorhinoplasty patients, a composite graft combining synthetic mesh with cartilage scored better on appearance and satisfaction than mesh alone, but had 17 complications against 2 in the mesh only group.

Overview

Achieving lasting tip projection and lengthening in Asian rhinoplasty is difficult because the nasal septum is small and weak, and there is often not enough septal cartilage available. This retrospective study, conducted in Seoul between January 2017 and December 2019, compared two ways of using polycaprolactone mesh, a synthetic absorbable material, to support the tip.

Sections of note

Retrospective study of 774 patients having septorhinoplasty with polycaprolactone mesh.
Two groups were compared: mesh only graft and composite mesh plus cartilage graft.
Appearance was rated above 3 in 97.5 percent of the composite group against 90.4 percent of the mesh only group, P equals 0.0002.
Satisfaction was rated more than satisfied by 96.7 percent of the composite group against 94.3 percent of the mesh only group, P equals 0.0365.
Seventeen patients in the composite group had complications including decreased tip projection, deviated tip, mesh infection and mesh exposure.
Two patients in the mesh only group had a complication, which the abstract states as mesh injection.
The authors conclude the composite graft gives robust support to a modified and lengthened nose.

What it means for a patient

The composite graft scored higher on appearance and satisfaction but had more complications in absolute numbers.
Mesh infection and mesh exposure are complications specific to using a synthetic material inside the nose.
Group sizes are not stated separately, so the complication rates cannot be compared directly.
This is a retrospective single centre study, and the follow up duration is not stated.

Why this paper matters

Synthetic mesh is used in Asian rhinoplasty to compensate for limited septal cartilage, and the trade off is between support and the risks of a foreign material. This large series compares two ways of deploying it. The absence of denominators and follow up length limits what the complication counts can show.

Terms

Polycaprolactone mesh: a synthetic material that the body gradually absorbs, used as a scaffold.
Composite graft: a graft combining two materials, here mesh plus cartilage.
Septal extension graft: a graft attached to the septum to set the position and projection of the tip.
Mesh exposure: the mesh becoming visible through the skin or lining.
Tip projection: how far the tip stands out from the face.

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

From the abstract

“Despite the great demand of aesthetic rhinoplasty in Asian population, it is difficult to obtain the lasting ideal tip projection along with lengthening of the nose due to the small and weak nasal septum. The shortage of available septal cartilage to work with is another major obstacle. A retrospective study was…”

Excerpt; the full abstract is on PubMed.