During the past 6 years the authors have treated 406 patients with classic silicone augmentation rhinoplasty. The types and incidence of complications after subcutaneous or subfascial implantation are examined and discussed. They propose that most complications are related to the depth of the implant and the character of the tissues. To improve their operation and to prove their hypothesis, they performed subperiosteal augmentation rhinoplasty in 22 patients with satisfactory results. At the same time, they investigated the biomechanical properties of human nasal periosteum and fascia, including tensile strength, the stress–strain relationship, and stress relaxation characteristics under uniaxial tension. Although it has less failure strain, the periosteum has more tensile strength than fascia. So, in the view of biomechanics, the periosteum is thicker, tougher, and stiffer than fascia, and thus more suitable for covering silicone implants.
Biomechanical testing on fresh cadaver nasal tissue demonstrated that subperiosteal placement of a silicone implant should be superior to subfascial placement. Twenty-two augmentation rhinoplasties were successfully performed with subperiosteal placement of the implant.
*Biomedical Engineering Center, Beijing Polytechnic University, PRC; the †Hangzhou Orthopaedic Hospital, Peoples Republic of China; the ‡University of Wisconsin, Madison, WI; §Alborg University, Alborg, Denmark; and ¶Medical School, Shantou University, Shantou, China.
Received Dec 14, 2001, and
in revised form Apr 12, 2002.
Accepted for publication Apr 12, 2002.
Address correspondence and reprint requests to Dr Zeng, Biomechanics & Medical Information Institute, Beijing Polytechnic University, Beijing 100022, PRC.
Supported by the Chinese National Nature Science Foundation.
Zeng Y, Wu W, Yu H, Yang J, Chen G. Silicone implant in augmentation rhinoplasty.