Complications Associated with Alloplastic Materials in Rhinoplasty and Their Operative Management

Storck K, Kotz S, Riedel F, Veit J.

What this paper says

Eighteen patients with infected or extruding synthetic dorsal implants (15 placed in Asia, 3 in Germany) were treated in one stage by removing the implant and rebuilding the bridge with the patient's own rib cartilage, with satisfying results.

Overview

Synthetic implants are widely used for dorsal augmentation in Asia, and the German authors report their experience treating the failures. All 18 patients had recurrent foreign-body infection and/or partial extrusion. After antibiotic control, a single-stage revision removed the implant and reconstructed the dorsum with solid rib, diced cartilage in fascia, or diced cartilage in platelet-rich fibrin, with antibiotics before, during and after. Follow-up used examination, ultrasound, 2D/3D imaging and MRI.

Sections of note

18 patients; augmentation done in Asia (15) or Germany (3).
All had recurrent infection signs and/or partial extrusion.
One-stage explantation and autologous rib reconstruction in every case.
Dorsal options: solid rib graft, diced cartilage in fascia, or free diced cartilage in platelet-rich fibrin.
Stated risks of implants: foreign-body reaction, recurrent infection, uncontrolled scarring, unsatisfying long-term results.

What it means for a patient

Silicone and similar implants can fail years later with infection or the implant working through the skin.
Removal and rebuilding with the patient's own cartilage can be done in one operation once infection is controlled.
Rib harvest is required, which the original implant was chosen to avoid.

Why this paper matters

It documents the salvage pathway for implant failures and introduces ultrasound and 3D imaging for follow-up. Limits: 18 patients, no outcome scores, no comparison.

Terms

Alloplastic material: a synthetic implant such as silicone or ePTFE.
Extrusion: an implant pushing through the skin or lining.
Explantation: surgical removal of an implant.
Diced cartilage in fascia (DCF): chopped cartilage wrapped in fascia to shape the bridge.
Platelet-rich fibrin (PRF): a clot-like preparation of the patient's blood used to bind diced cartilage.

Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows.

From the abstract

“Whereas rhinoplasty with a reduction of the dorsum and modification of the tip is a common procedure among Caucasians, augmentation of the dorsum remains a challenge in Asians. Choice of the ideal grafting material for dorsal augmentation is a matter of preference and remains under discussion. Autologous and…”

Excerpt; the full abstract is on PubMed.