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February 9, 2026Open Access

Single-stage Septal Framework Reconstruction After Alloplastic Implant Failure Using Autologous Costal Cartilage

GAGeorgy Aleksanrovich AganesovSechenov University VSV.I. SharobaroSechenov University YKYulia A. KopylovaSechenov University

Key Points

The aim is to evaluate the safety and effectiveness of single-stage septal framework reconstruction using autologous costal cartilage following porous polyethylene implant failure.
Reported two cases of nasal deformity post-porous polyethylene implant failure.
Performed single-stage removal of implants and immediate reconstruction with autologous costal cartilage.
Used a triple transosseous suture for fixation through a single bony tunnel.
Assessed outcomes using FACE-Q and Rhinoplasty Outcome Evaluation scores.
Both patients remained infection-free post-surgery.
FACE-Q scores improved from an average of 2.4 to 4.0.
Patient 1's Rhinoplasty Outcome Evaluation scores increased from 7 to 20, and Patient 2's from 9 to 21.
No graft resorption or structural compromise occurred.

Abstract

Summary: Porous polyethylene implants are widely used in rhinoplasty but are associated with complications, including infection, extrusion, and framework destruction. Managing such complications is challenging, often requiring staged reconstruction. Autologous costal cartilage remains the gold standard for structural support due to its durability and biocompatibility. We reported 2 cases of severe nasal deformity following the use of porous polyethylene implants. Both patients underwent single-stage removal of the implants with immediate septal framework reconstruction using autologous costal cartilage harvested from the eighth rib. Fixation was achieved with a triple transosseous suture through a single bony tunnel in the nasal spine. Outcomes were assessed clinically and with validated patient-reported outcome measures, including the FACE-Q and Rhinoplasty Outcome Evaluation. Patient 1 (34 years old) was followed up for 12 months; patient 2 (36 years old) was followed up for 6 months. Both remained infection-free after surgery. FACE-Q scores improved from an average of 2.4 preoperatively to 4.0 postoperatively. Rhinoplasty Outcome Evaluation scores improved from 7 out of 24 to 20 out of 24 in patient 1 and from 9 out of 24 to 21 out of 24 in patient 2. No graft resorption, structural compromise, or revision procedures were observed. Aesthetic outcomes were stable, and functional breathing improved in both cases. Single-stage autologous costal cartilage reconstruction after implant failure is safe and effective, even in cases with active infection. This approach restores both function and aesthetics without staged procedures or revision surgery.

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