Complications Associated with Use of Porous High-Density Polyethylene in Rhinoplasty.

Porous high-density polyethylene (pHDPE) has successfully been used as an alternative to cartilage for grafting in rhinoplasty; however, concerns exist surrounding its potential for infection and/or extrusion. To analyze the relationship between complication rates associated with pHDPE in rhinoplasty and graft location relative to shear force applied by external manipulation. Retrospective review of 116 patients undergoing pHDPE rhinoplasty for 10 years. Minor postoperative complications occurred in 3.4% of patients, each resolving with conservative management. Major complications including infection or extrusion occurred in 5.2% of all patients, at an average of 36.9 months postoperatively. All major complications occurred in patients with grafts extending into the caudal nose, and two-thirds ultimately necessitated surgical intervention. Cephalically contained pHDPE grafts are less prone to failure than those extending into the caudal nose. Long-term follow-up is recommended for all patients based on the risk for delayed complications.