Use of Integra™ in Rhinoplasty

Chapter

Abstract

Different biosynthesized materials and autologous grafts have been used during many years so as to increase the size or to change the shape of the nasal dorsum in augmentation rhinoplasty. In order to avoid the nondesired effects of these materials, such as reabsorption, intolerance, granulomas, visualization of the graft edges, or the migration of the implant, we propose a new technique using a dermal regeneration template (Integra™). The advantage of using this material, one made of a sheet of porous matrix of collagen fibers and glycosaminoglycans, is that it provides us with a structure for the autologous dermic tissue regeneration. Its versatility when handling, once the silicone sheet is removed, allows us to fold it over itself until the needed thickness is obtained as well as the desired aesthetic results. The dermal regeneration template (Integra™) is a nice alternative filler material since it is completely reabsorbed and replaced by autologous dermis. The action is not to replace but to help the development of the own tissue, avoiding a possible intolerance, because it does not act as a foreign body. Volume remains throughout time, and it is not necessary an overcorrection.

Keywords

Demineralized Bone Matrix Regeneration Template Dice Cartilage Saddle Nose Deformity Platelet Growth Factor 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Jackson IT, Smith J, Mixter RC (1983) Nasal bone grafting using split skull grafts. Ann Plast Surg 11(6):533–540PubMedCrossRefGoogle Scholar
  2. 2.
    Inanli S, Sari M, Baylancicek S (2007) The use of expanded polytetrafluoroethylene (Gore-Tex) in rhinoplasty. Aesthetic Plast Surg 31(4):345–348PubMedCrossRefGoogle Scholar
  3. 3.
    Bottini DJ, Gentile P, Donfrancesco A, Fiumara L, Cervelli V (2008) Augmentation rhinoplasty with autologous grafts. Aesthetic Plast Surg 32(1):136–142PubMedCrossRefGoogle Scholar
  4. 4.
    Tosun Z, Karabekmez FE, Keskin M, Duymaz A, Savaci N (2008) Allogenous cartilage graft versus autogenous cartilage graft in augmentation rhinoplasty: a decade of clinical experience. Aesthetic Plast Surg 32(2):252–260PubMedCrossRefGoogle Scholar
  5. 5.
    Yilmaz M, Vayvada H, Menderes A, Mola F, Atabey A (2007) Dorsal nasal augmentation with rib cartilage graft: long-term results and patient satisfaction. J Craniofac Surg 18(6):1457–1462PubMedCrossRefGoogle Scholar
  6. 6.
    Clark RP, Wong G, Johnson LM, Hagge RJ, Ciminello F, Lee J, Stone KI, Clark IA (2009) Nasal dorsal augmentation with freeze-dried allograft bone. Plast Reconstr Surg 124(4):1312–1325PubMedCrossRefGoogle Scholar
  7. 7.
    Gómez Morell PA, Paolo Domenech R (2007) Uso del regenerador dérmico Integra como material de relleno para el tratamiento de defectos del contorno corporal. Cir Plast Iberolatinoam 33(3):195–200Google Scholar
  8. 8.
    Stern R, McPherson M, Pharm D, Longaker T (1990) Histologic study of artificial skin used in the treatment of full-thickness thermal injury. J Burn Care Rehabil 11(1):7–13PubMedCrossRefGoogle Scholar
  9. 9.
    Hembach D, Luterman A, Burke J (1988) Artificial dermis for major burns, a multi-center randomized clinical trial. Ann Surg 208:313CrossRefGoogle Scholar
  10. 10.
    Dantzer E, Queruel P, Salier L (2001) Integra, a new surgical alternative for the treatment of massive burns. Clinical assessment of acute surgery and reconstructive surgery on 39 cases. Ann Chir Plast Esthet 46:173–189PubMedCrossRefGoogle Scholar
  11. 11.
    Moiemen N, Vlachou E, Staiano J (2006) Reconstructive surgery with Integra dermal regeneration template: histologic study, clinical evaluation and current practice. Plast Reconstr Surg 117:160s–174sPubMedCrossRefGoogle Scholar
  12. 12.
    Sheridan R, Hegarty M, Tompkins R, Burke J (1994) Artificial skin in massive burns-results to ten years. Eur J Plast Surg 17:91–93Google Scholar
  13. 13.
    Gryskiewicz JM, Rohrich RJ, Reagan BJ (2001) The use of alloderm for the correction of nasal contour deformities. Plast Reconstr Surg 107(2):561–570PubMedCrossRefGoogle Scholar
  14. 14.
    Gryskiewicz JM, Not W, Not W (2005) The use of AlloDerm in secondary rhinoplasty. Plast Reconstr Surg 116(7):1999–2004PubMedCrossRefGoogle Scholar
  15. 15.
    Karaaltin MV, Orhan KS, Demirel T (2009) Fascia lata graft for nasal dorsal contouring in rhinoplasty. J Plast Reconstr Aesthet Surg 62(10):1255–1260PubMedCrossRefGoogle Scholar
  16. 16.
    Erdogan B, Tuncel A, Adanali G, Deren O, Ayhan M (2003) Augmentation rhinoplasty with dermal graft and review of the literature. Plast Reconstr Surg 111(6):2060–2068PubMedCrossRefGoogle Scholar
  17. 17.
    Erol OO (2000) The Turkish delight: a pliable graft for rhinoplasty. Plast Reconstr Surg 105(6):2229–2241PubMedCrossRefGoogle Scholar
  18. 18.
    Daniel RK (2008) Diced cartilage grafts in rhinoplasty surgery: current techniques and applications. Plast Reconstr Surg 122(6):1883–1891PubMedCrossRefGoogle Scholar
  19. 19.
    Calvert JW, Brenner KB, Da Costa-Iyer M, Evans GRD, Daniel RK (2006) Histological analysis of human diced cartilage grafts. Plast Reconstr Surg 118:230PubMedCrossRefGoogle Scholar
  20. 20.
    Palao R, Gómez P, Huguet P (2003) Burned breast reconstructive surgery with Integra dermal regeneration template. Br J Plast Surg 56:252PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Clinica PlanasBarcelonaSpain

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