Several types of alloplastic materials have been, and continue to be,
used for dorsal and tip augmentation in rhinoplasty.1-11
We believe implants have a valuable role in rhinoplasty, provided the right
implant material is chosen and the correct technique is used for the proper
indication. Some different types of alloplastic implants used in rhinoplasty
are as follows: polytetrafluoroethylenes, the most common being Gore-Tex (W.
L. Gore Associates, Inc, Flagstaff, Ariz); silicone rubber (such as Silastic);
polyethylene, such as Medpore (Porex, Fairburn, Ga) and Plastipore (Richards
Manufacturing Company, Memphis, Tenn) and polyesters and polyamides, such
as Dacron (Ethicon Inc, Somerville, NJ), Mersilene (Ethicon Inc), Supramid7 (S. Jackson Inc, Alexandria, Va), and the Cooley Dacron
knitted implant (Meadox; Boston Scientific, Quincy, Mass). Dacron material
implants have been extensively used in cardiovascular surgery, with the results
of many long-term follow-up studies reported in the medical literature.12-17
Dacron fabric (Cooley) is a polyethylene terephthalate woven into a tight
nonresorbable mesh. It is a multifilament fabric supplied as a white fabric
sheet. Its design allows minimal tissue ingrowth that is enough to maintain
the implant position. The multifilament arrangement makes the implant not
slippery during surgery; therefore, it stays wherever it is placed and almost
sticks to its bed or to the overlying skin. In addition, this implant may
be handled, cut, and shaped easily while retaining a certain degree of body.
It does not shred, as encountered with other Dacron-type materials, such as
Mersilene mesh. In addition, its soft nature makes it difficult to detect
by skin palpation or visual inspection, even years after being implanted.