eMedicine Specialties > Plastic Surgery > Nose

Rhinoplasty, Maxillary Augmentation: Follow-up

Author: Michael Mercandetti, MD, MBA, FACS, Consulting Staff, Department of Surgery, Doctors Hospital of Sarasota
Coauthor(s): Adam J Cohen, MD, Assistant Professor, Department of Ophthalmology, Northwestern University Feinberg School of Medicine; Consulting Surgeon, Myers Wyse Center for the Eye; Director, Center for Facial Rejuvenation; Founding Partner, HC Consulting, Inc; Edward W Chang, MD, DDS, Consulting Staff, Department of Cosmetic Services, Head and Neck Surgery, Kaiser Permanente of Northern California at Santa Rosa; Edward Farrior, MD, Clinical Associate Professor, Department of Otolaryngology-Head and Neck Surgery, University of South Florida Health Sciences Center; Donald R Laub Jr, MS, MD, FACS, Associate Professor of Surgery and Pediatrics, University of Vermont College of Medicine; Interim Chief, Plastic and Reconstructive Surgery, Fletcher Allen Health Care
Contributor Information and Disclosures

Updated: Apr 2, 2008

Outcome and Prognosis

Most of the implant material is nonautogenous in nature. Silicone is relatively inert and has a long history of being well tolerated by the body. Infection can occur with any implanted material in the body. If this were to occur with the silicone implant, it would necessitate removal.

Slippage of the implant can also occur if the pocket is too large. Autogenous material such as cartilage is seldom used in this area. The increased effort to harvest this material and shave it is not often warranted. Septal cartilage can be fashioned into a maxillary onlay graft but "results in the long run may be less predictable than alloplastic correction.”7

The patient and surgeon ultimately decide which implant material to use.

Future and Controversies

Newer imaging capabilities allowing for more readily available customizable implant creation will become more prevalent. This technology, coupled with newer implant materials, will lead to less traumatic surgical techniques and elevated patient and physician satisfaction levels.

 


More on Rhinoplasty, Maxillary Augmentation

Overview: Rhinoplasty, Maxillary Augmentation
Workup: Rhinoplasty, Maxillary Augmentation
Treatment: Rhinoplasty, Maxillary Augmentation
Follow-up: Rhinoplasty, Maxillary Augmentation
Multimedia: Rhinoplasty, Maxillary Augmentation
References

References

  1. Cinelli JA. Correction of combined elongated nose and recessed naso-labial angle. Plast Reconstr Surg. Feb 1958;21(2):139-42. [Medline].

  2. Byrd HS, Hobar PC. Alloplastic nasal and perialar augmentation. Clin Plast Surg. Apr 1996;23(2):315-26. [Medline].

  3. Hinderer UT. Nasal base, maxillary, and infraorbital implants--alloplastic. Clin Plast Surg. Jan 1991;18(1):87-105. [Medline].

  4. Watanabe T, Matsuo K. Augmentation with cartilage grafts around the pyriform aperture to improve the midface and profile in binder's syndrome. Ann Plast Surg. Feb 1996;36(2):206-11. [Medline].

  5. Cook TA, Wang TD, Brownrigg PJ, Quatela VC. Significant premaxillary augmentation. Arch Otolaryngol Head Neck Surg. Oct 1990;116(10):1197-201. [Medline].

  6. Converse JM, Horowitz SL, Valauri AJ, Montandon D. The treatment of nasomaxillary hypoplasia. A new pyramidal naso-orbital mazillary osteotomy. Plast Reconstr Surg. Jun 1970;45(6):527-35. [Medline].

  7. Flowers RS. Augmentation maxilloplasty. In: Terino EO, Flowers RS, eds. The Art of Alloplastic Facial Contouring. Mosby: St Louis; 2000:129-150.

  8. Romo T 3rd, Shapiro AL. Aesthetic reconstruction of the platyrrhine nose. Arch Otolaryngol Head Neck Surg. Aug 1992;118(8):837-41. [Medline].

  9. Brink RR. Premaxillary augmentation. In: Terino EO, Flowers RS, eds. The Art of Alloplastic Facial Contouring. St Louis: Mosby; 2000:119-127.

  10. Tolleth H. Aesthetics and plastic surgery. In: Terino EO, Flowers RS, eds. The Art of Alloplastic Facial Contouring. Mosby: St Louis; 2000:3-11.

  11. Fanous N, Yoskovitch A. Premaxillary augmentation for central maxillary recession: an adjunct to rhinoplasty. Facial Plast Surg Clin North Am. Nov 2002;10(4):415-22. [Medline].

  12. Foda HM. Mersiline mesh in premaxillary augmentation. Aesthetic Plast Surg. May-Jun 2005;29(3):169-73. [Medline].

  13. Mathog RH, Leonard M, Bevis R. Surgical correction of maxillary hypoplasia. Arch Otolaryngol. Jul 1979;105(7):399-403. [Medline].

  14. Nassif PS, Kokoska MS. Aesthetic Facial Analysis. Facial Plast Surg Clin of North Am. November 1999;7(1):4.

Further Reading

Keywords

maxillary augmentation, premaxillary augmentation, maxillary retrusion, maxillary hypoplasia, craniofacial anomalies, Apert syndrome, Crouzon syndrome, rhinoplasty, midfacial retrusion, midface retrusion, lower jaw, prognathic, prognathic profile, columella-labial angle correction, maxillary bone, underdeveloped maxilla, maxilla, maxilla development, maxilla correction, intranasal approach, intraoral approach

Contributor Information and Disclosures

Author

Michael Mercandetti, MD, MBA, FACS, Consulting Staff, Department of Surgery, Doctors Hospital of Sarasota
Michael Mercandetti, MD, MBA, FACS is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Ophthalmology, American College of Surgeons, American Society for Laser Medicine and Surgery, American Society of Ophthalmic Plastic and Reconstructive Surgery, Association of Military Surgeons of the US, and Sarasota County Medical Society
Disclosure: Nothing to disclose.

Coauthor(s)

Adam J Cohen, MD, Assistant Professor, Department of Ophthalmology, Northwestern University Feinberg School of Medicine; Consulting Surgeon, Myers Wyse Center for the Eye; Director, Center for Facial Rejuvenation; Founding Partner, HC Consulting, Inc
Adam J Cohen, MD is a member of the following medical societies: American Academy of Ophthalmology and American College of Surgeons
Disclosure: Nothing to disclose.

Edward W Chang, MD, DDS, Consulting Staff, Department of Cosmetic Services, Head and Neck Surgery, Kaiser Permanente of Northern California at Santa Rosa
Edward W Chang, MD, DDS is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, and California Medical Association
Disclosure: Nothing to disclose.

Edward Farrior, MD, Clinical Associate Professor, Department of Otolaryngology-Head and Neck Surgery, University of South Florida Health Sciences Center
Edward Farrior, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, and Florida Medical Association
Disclosure: Nothing to disclose.

Donald R Laub Jr, MS, MD, FACS, Associate Professor of Surgery and Pediatrics, University of Vermont College of Medicine; Interim Chief, Plastic and Reconstructive Surgery, Fletcher Allen Health Care
Donald R Laub Jr, MS, MD, FACS is a member of the following medical societies: American Association for Hand Surgery, American Cleft Palate/Craniofacial Association, American College of Surgeons, American Society for Surgery of the Hand, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, AO Foundation, International College of Surgeons, International College of Surgeons US Section, Northeastern Society of Plastic Surgeons, and Vermont State Medical Society
Disclosure: Nothing to disclose.

Medical Editor

Fred Menick, MD, Clinical Associate Professor, Department of Surgery, Division of Plastic Surgery, University of Arizona
Fred Menick, MD is a member of the following medical societies: American Association of Plastic Surgeons, American Society for Aesthetic Plastic Surgery, and American Society of Plastic Surgeons
Disclosure: none None None

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

George Peck, Jr, MD, Consulting Staff, Department of Plastic Surgery, St Barnabas Hospital of New Jersey
George Peck, Jr, MD is a member of the following medical societies: American Society for Aesthetic Plastic Surgery
Disclosure: Nothing to disclose.

CME Editor

Nicolas (Nick) G Slenkovich, MD, Practice Director, Colorado Plastic Surgery Center at Swedish Medical Center
Nicolas (Nick) G Slenkovich, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Medical Association, American Society of Plastic Surgeons, and Colorado Medical Society
Disclosure: Nothing to disclose.

Chief Editor

Deepak Narayan, MD, FRCS, Associate Professor of Surgery (Plastic), Yale University School of Medicine; Chief of Plastic Surgery, West Haven Veterans Affairs Medical Center
Deepak Narayan, MD, FRCS is a member of the following medical societies: American Association for the Advancement of Science, American College of Surgeons, American Medical Association, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, Indian Medical Association, Plastic Surgery Research Council, Royal College of Surgeons of Edinburgh, and Royal College of Surgeons of England
Disclosure: Nothing to disclose.

 
 
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