Long-term results of high-density porous polyethylene implants in facial skeletal augmentation: An Indian perspective

Context: With the increasing emphasis on well-sculpted facial features, today there is a growing need for tools to augment the facial skeleton; either for cosmetic reasons or to re-contour deformities—congenital, post-traumatic and post-ablative. The limitations of autogenous materials has lead to e...

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Main Authors: Sanjeev Deshpande, Amarnath Munoli
Format: Article
Language:English
Published: Thieme Medical Publishers, Inc. 2010-01-01
Series:Indian Journal of Plastic Surgery
Subjects:
Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1699400
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author Sanjeev Deshpande
Amarnath Munoli
author_facet Sanjeev Deshpande
Amarnath Munoli
author_sort Sanjeev Deshpande
collection DOAJ
description Context: With the increasing emphasis on well-sculpted facial features, today there is a growing need for tools to augment the facial skeleton; either for cosmetic reasons or to re-contour deformities—congenital, post-traumatic and post-ablative. The limitations of autogenous materials has lead to evolution of numerous ‘alloplasts’, of which, high-density porous polyethylene (HDPE) seems to be a promising alternative. Aims: To evaluate the long term results of HDPE in facial skeletal augmentation in terms of achieving desired facial contour, patient satisfaction and complications. Settings: A tertiary care referral centre in a metropolitan set-up. Design: Case Series Materials and Methods: All patients undergoing HDPE implant insertion for facial skeletal augmentation between July 2001 and November 2009 were included in the study. A total of 70 HDPE implants were inserted in 44 patients. All procedures were performed by a single surgeon following standardized pre, intra and post-operative protocols. The results were evaluated with respect to improvement in facial contour desired and achieved, overall patient satisfaction and complications encountered. Results: The study included 44 patients with a male:female ratio of 1:1, a mean age of 25.09 years (14 to 58 years) and a mean follow-up of 45.34 months (0.5 to 100 months). HDPE implants were used to augment the nasal dorsum, maxilla, malar eminence, chin, mandibular body and angle, orbital rim and frontal region. The overall recontouring afforded by the HDPE implants was good, with most patients reporting satisfactory results. There were seven complications (10%), including three cases of deviation (4.29%), three cases of exposure (4.29%) and one case of sub-clinical infection (1.43%). None however necessitated implant removal. Nasal dorsal HDPE implants, especially those involving secondary surgery, suffered a much higher complication rate compared to other implants. Conclusions: HDPE is an alternative to autogenous grafts for facial skeletal augmentation with good long-term results and a low incidence of complications, provided there is adequate vascular soft tissue cover.
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spelling doaj.art-71eb23c74c7a4515927d628f919356252022-12-22T00:59:07ZengThieme Medical Publishers, Inc.Indian Journal of Plastic Surgery0970-03581998-376X2010-01-01430103403910.1055/s-0039-1699400Long-term results of high-density porous polyethylene implants in facial skeletal augmentation: An Indian perspectiveSanjeev Deshpande0Amarnath Munoli1Department of Plastic Surgery, Gokuldas Tejpal Hospital, Mumbai, IndiaDepartment of Plastic Surgery, Gokuldas Tejpal Hospital, Mumbai, IndiaContext: With the increasing emphasis on well-sculpted facial features, today there is a growing need for tools to augment the facial skeleton; either for cosmetic reasons or to re-contour deformities—congenital, post-traumatic and post-ablative. The limitations of autogenous materials has lead to evolution of numerous ‘alloplasts’, of which, high-density porous polyethylene (HDPE) seems to be a promising alternative. Aims: To evaluate the long term results of HDPE in facial skeletal augmentation in terms of achieving desired facial contour, patient satisfaction and complications. Settings: A tertiary care referral centre in a metropolitan set-up. Design: Case Series Materials and Methods: All patients undergoing HDPE implant insertion for facial skeletal augmentation between July 2001 and November 2009 were included in the study. A total of 70 HDPE implants were inserted in 44 patients. All procedures were performed by a single surgeon following standardized pre, intra and post-operative protocols. The results were evaluated with respect to improvement in facial contour desired and achieved, overall patient satisfaction and complications encountered. Results: The study included 44 patients with a male:female ratio of 1:1, a mean age of 25.09 years (14 to 58 years) and a mean follow-up of 45.34 months (0.5 to 100 months). HDPE implants were used to augment the nasal dorsum, maxilla, malar eminence, chin, mandibular body and angle, orbital rim and frontal region. The overall recontouring afforded by the HDPE implants was good, with most patients reporting satisfactory results. There were seven complications (10%), including three cases of deviation (4.29%), three cases of exposure (4.29%) and one case of sub-clinical infection (1.43%). None however necessitated implant removal. Nasal dorsal HDPE implants, especially those involving secondary surgery, suffered a much higher complication rate compared to other implants. Conclusions: HDPE is an alternative to autogenous grafts for facial skeletal augmentation with good long-term results and a low incidence of complications, provided there is adequate vascular soft tissue cover.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1699400high density porous polyethylenefacial skeletal augmentationalloplast
spellingShingle Sanjeev Deshpande
Amarnath Munoli
Long-term results of high-density porous polyethylene implants in facial skeletal augmentation: An Indian perspective
Indian Journal of Plastic Surgery
high density porous polyethylene
facial skeletal augmentation
alloplast
title Long-term results of high-density porous polyethylene implants in facial skeletal augmentation: An Indian perspective
title_full Long-term results of high-density porous polyethylene implants in facial skeletal augmentation: An Indian perspective
title_fullStr Long-term results of high-density porous polyethylene implants in facial skeletal augmentation: An Indian perspective
title_full_unstemmed Long-term results of high-density porous polyethylene implants in facial skeletal augmentation: An Indian perspective
title_short Long-term results of high-density porous polyethylene implants in facial skeletal augmentation: An Indian perspective
title_sort long term results of high density porous polyethylene implants in facial skeletal augmentation an indian perspective
topic high density porous polyethylene
facial skeletal augmentation
alloplast
url http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1699400
work_keys_str_mv AT sanjeevdeshpande longtermresultsofhighdensityporouspolyethyleneimplantsinfacialskeletalaugmentationanindianperspective
AT amarnathmunoli longtermresultsofhighdensityporouspolyethyleneimplantsinfacialskeletalaugmentationanindianperspective