Polypropylene meshes and other alloplastic implants for soft tissue and cartilage nasal reconstructive surgery – a literature review

BACKGROUND. The reconstructive surgery is a domain in continuous research for new techniques and alloplastic materials for replacement of complex defects. Different biomaterials are used in soft tissue reconstruction including polypropylene meshes covered with collagen, which have the best results in abdominal and pelvic surgery, but are not yet used in nasal surgery.

MATERIAL AND METHODS. We analysed the studies from the literature regarding the different alloplastic implants used in nasal reconstruction surgery, their benefits and contraindications for nasal defects.

RESULTS. The most used polymers are Silicone, Medpor^®, Mersilene^® and polypropylene. Silicone is no longer widely used in facial reconstructive surgery because of its many complications. Medpor^® (high-density polyethylene) is used for reconstruction of the facial skeleton and for aesthetic contour enhancement, including nasal reconstruction. Mersilene^® (polyethylene terephthalate) is used for dorsum nasal defect reconstruction. Gore-Tex^® is used for soft-tissue augmentation in the nose and is not recommended as a structural graft. Polypropylene meshes (Marlex^®) are widely used in abdominal and chest wall reconstructive surgeries, with few studies on using them in nasal cartilage reconstruction.

CONCLUSION. Nasal reconstructive surgery is a difficult part of plastic surgery than can cause many problems to the surgeon, the need for soft tissue and cartilage reconstruction are difficult to solve in a repeatedly operated nose with few autogenous graft options and complex reconstructive surgeries, especially in posttraumatic defects and revision rhinoplasties. There are many alloplastic implants that can be used with excellent results.