Complications associated with alloplastic implants in rhinoplasty

Arch Facial Plast Surg. 2012 Nov;14(6):437-41. doi: 10.1001/archfacial.2012.583.


Objective: To evaluate the incidence of infection and extrusion of porous high-density polyethylene (pHDPE) and expanded polytetrafluoroethylene (ePTFE) implants used in rhinoplasty at a high-volume, academic facial plastic surgery practice.

Methods: A total of 662 rhinoplasty procedures performed by 3 faculty surgeons from 1999 to 2008 were retrospectively reviewed. Patient demographics, medical comorbidities, operative details, and postoperative course findings were collected from patient records.

Results: The incidence of postoperative infection was 2.8% (19 of 662 patients). In each case of infection, alloplastic material had been used. Infections occurred in 1 in 5 rhinoplasty procedures in which pHDPE implants were used. In patients in whom ePTFE was used alone, the infection rate was 5.3%. Exposure developed in 12% of patients in whom an alloplast was used during surgery. Factors notably not associated with infection on bivariate analysis included sex, surgeon, purpose of procedure (functional vs cosmetic), current tobacco use, or history of cocaine use (P > .05 for all).

Conclusions: To our knowledge, this study represents the largest evaluation of the use of pHDPE implants in rhinoplasty to date. Our findings are in contrast to those of previous studies regarding the use of pHDPE in rhinoplasty and parallel to those regarding the use of ePTFE. Caution is strongly recommended when considering the use of pHDPE in rhinoplasty.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biocompatible Materials / adverse effects*
  • Child
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Outcome Assessment, Health Care
  • Polyethylenes / adverse effects*
  • Polytetrafluoroethylene / adverse effects*
  • Prostheses and Implants / adverse effects*
  • Prosthesis Failure / etiology*
  • Prosthesis-Related Infections / epidemiology
  • Prosthesis-Related Infections / etiology*
  • Retrospective Studies
  • Rhinoplasty / instrumentation*
  • Rhinoplasty / methods
  • Young Adult


  • Biocompatible Materials
  • Medpor
  • Polyethylenes
  • Polytetrafluoroethylene