Gore-tex nasal augmentation: A 26-year perspective

Objective: To determine on an ongoing basis the safety and efficacy of expanded polytetrafluoroethylene (Gore- Tex soft tissue patch and preformed nasal implants) as an implant in rhinoplasty. Design: A retrospective study of 309 consecutive patients who underwent rhinoplasty, including augmentation with Gore-Tex, during a 10-year period. Setting: Two major academic medical centers and 2 private office surgical centers. Intervention: One hundred sixty-two patients (52%) presented for primary rhinoplasty; the remaining 147 (48%) presented for revision surgery. All received Gore-Tex implants to augment the nasal dorsum and/or base. The grafts ranged from 1 to 10mmin thickness. Follow-up ranged from 5 months to 10 years, 5 months, with an average of 40.4 months. Main Outcome Measures: Clinically noted complications and patient satisfaction. Results: Ten (3.2%) of 309 grafts became infected and were removed. One graft was removed and 1 graft was modified and replaced postoperatively because of excessive augmentation. Infection requiring removal occurred in 8 patients (5.4%) undergoing revision rhinoplasty and in 2 patients (1.2%) undergoing primary rhinoplasty. Nasal septal perforation was present preoperatively in 3 of the patients who developed infection requiring removal, and we consider it a contraindication for nasal Gore-Tex implantation. Conclusions: Gore-Tex remains an effective implant material for nasal augmentation in rhinoplasty. The complication rate in primary cases is low. The risk of infection necessitating removal rises significantly in revision cases, where its use may still be desirable but must be weighed more carefully.