Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2024; 12(18): 3351-3359
Published online Jun 26, 2024. doi: 10.12998/wjcc.v12.i18.3351
Complicated calcified alloplastic implants in the nasal dorsum: A clinical analysis
Yong-Seon Hwang, Taek-Kyun Kim, Dong-Jun Yang, Si-Hyong Jang, Da-Woon Lee
Yong-Seon Hwang, Da-Woon Lee, Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University, Cheonan-Si 31151, South Korea
Taek-Kyun Kim, Department of Plastic Surgery, The PLUS Plastic Surgery Clinic, Seoul 06035, South Korea
Dong-Jun Yang, Department of Plastic Surgery, CDU Plastic Surgery Clinic, Seoul 06067, South Korea
Si-Hyong Jang, Department of Pathology, College of Medicine, Soonchunhyang University, Cheonan 31151, Chungcheongnam-do, South Korea
Author contributions: Lee DW and Kim TK for conceptualization; Lee DW, Kim TK, and Yang DJ for data compilation and analysis; Hwang YS for investigation; Kim TK and Yang DJ for resources; Lee DW and Hwang YS for preparation of the original draft of the writing; Hwang YS, Lee DW, and Jang SH for visualization and analysis; Lee DW for supervision and obtaining funding; Lee DW, Kim TK and Yang DJ for project management. All authors have read and agreed to the published version of the manuscript.
Supported by The Soonchunhyang University Research Fund, No. 2024-0022.
Institutional review board statement: The study protocol was approved by the Institutional Review Board (IRB number: 2023-11-062).
Informed consent statement: The patient provided informed consent for the publication.
Conflict-of-interest statement: The authors declare no conflict of interest.
Data sharing statement: Data are available from the authors upon reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Da-Woon Lee, MD, Professor, Surgeon, Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University, Suncheonhyang 6-gil 31, Cheonan-Si 31151, South Korea. 103022@schmc.ac.kr
Received: January 1, 2024
Revised: April 12, 2024
Accepted: May 9, 2024
Published online: June 26, 2024
Processing time: 168 Days and 13.4 Hours
Abstract
BACKGROUND

In rhinoplasty, calcification around silicone implants is frequently observed in the tip dorsum (TD) area. Additionally, based on a review of various literature, it is presumed that calcification in silicone implants occurs due to both inflammatory chemical reactions and physical friction against the tissue. The calcification of nasal silicone implants not only results in the functional loss of the implants, but also leads to material deformation. However, there is a lack of research on calcification of nasal silicone implants in the current literature.

AIM

To elucidate various clinical characteristics of calcification around nasal silicone implants, using histological and radiological analysis.

METHODS

This study analyzed data from 16 patients of calcified nasal implants, who underwent revision rhinoplasty for various reasons after undergoing augmentation rhinoplasty with silicone implants. The collected data included information on implant duration, implant types, location of calcification, presence of inflammatory reactions, and computed tomography (CT) scans.

RESULTS

The most common location of calcification, as visually analyzed, was in the TD area, accounting for 56%. Additionally, the analysis of CT scans revealed a trend of increasing Hounsfield Unit values for calcification with the duration of implantation, although this trend was not statistically significant (P = 0.139).

CONCLUSION

Our study shows that reducing the frequency of calcification may be achievable by using softer silicone implants and by minimizing the damage to perioperative tissues.

Keywords: Silicone implants, Rhinoplasty, Calcification, Complication, Hounsfield unit

Core Tip: Due to its relatively safe biocompatibility and stability, silicone is widely used as a material for nasal implants in rhinoplasty. However, calcification of silicone implants in the nose results in both aesthetic and functional loss of the implants. This study, through clinical analysis of calcification in silicone nasal implants, suggests that the highest frequency occurs in the tip dorsum area. It hypothesizes that the cause of calcification is attributed to both inflammatory reactions and continuous friction against the tissue. Therefore, using softer forms of silicone and minimizing tissue damage during surgery, could reduce the complications associated with calcification.