Autologous Auricular Cartilage-Augmented Porous High-Density Polyethylene Grafts for Nasal Tip Plasty in Female Revision Rhinoplasty

自体耳软骨增强多孔高密度聚乙烯移植物用于女性鼻尖成形术修复

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Abstract

BACKGROUND: Although porous high-density polyethylene (pHDPE) is increasingly utilized in East Asian rhinoplasty, complications like perforation remain problematic. OBJECTIVES: This study evaluated autologous auricular cartilage-augmented pHDPE grafts for nasal tip plasty in Chinese female revision rhinoplasty cases. METHODS: In this retrospective study (June 2021-June 2023), 76 patients from a Chinese tertiary hospital were divided into pHDPE group (n = 34, 32.71 ± 6.32 years) receiving pHDPE grafts and traditional group (n = 42, 31.92 ± 7.17 years) using costal cartilage. When necessary, both groups received expanded polytetrafluoroethylene dorsal augmentation. Outcomes included operative metrics (operation time [OT], complications incidence rate, postoperative pain score [PPS], nasal ventilation function autonomy score, and nasal tip material contraction rate [NTMCR]) and aesthetic parameters (nasolabial angle [NA], nasal tip angle, nasal tip projection, nasal bridge length index, nasal shape autonomy score). RESULTS: The pHDPE group demonstrated superior outcomes: shorter OT (2.88 ± 0.36 h vs 3.45 ± 0.48 h, P < .001), reduced PPS (1.68 ± 0.38 vs 5.12 ± 1.88, P < .001), optimized NA (97.82 ± 2.94° vs 100.41 ± 3.82°, P = .002), and lower NTMCR (4.56 ± 1.13% vs 8.78 ± 2.87%, P < .001). CONCLUSIONS: Auricular cartilage-augmented pHDPE grafts show significant advantages in operative efficiency, postoperative pain, and implanted material contraction rate for revision rhinoplasty; furthermore, the multi-layered support structure did not compromise the nasal cavity's ventilation function, suggesting clinical promise for East Asian patients.

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