Table 1 Approaches to nasal dorsum augmentation

Cartilage graft

Usage of different cartilage sources (septal, auricular, costal), handcrafted

Autologous material

Possible long-term deformation, partial resorption

[1, 36]

Turkish delight

Use of autologous cartilage and fascia

Partially autologous material, easily to produce and to form

Partial resorption and deformation, allograft (fascia)

[37, 38]

Bone graft

Mostly taken from rib (also as costal cartilage with adjacent rib) or calvarial bone

Stability, less warping, resembling bone–cartilage parts of the nose

Donor site morbidity, partially unnatural biomechanics

[39, 40]

Gore-Tex

Synthetic, sponge like materials

Easy to use, soft, shapeable, tissue ingrowth possible

Extrusion, foreign body reaction

[41, 42]

Polyethylene

Biomaterial with porous structure, e.g., Medpor

Low inflammatory reaction, ingrowth of surrounding tissue

Extrusion, infection, stiffness

[43]

Silicone implant

Preformed implant

Easy to use, cheap

Extrusion, dislocation, unnatural feeling, capsular formation, deformation of the nose

[44]

Fillers

Hyaluronic acid derivatives, calcium hydroxylapatite gel

Easy to use, resorbable (hyaluronic), long-term stable (hydroxylapatite), easy dosing

Infection, necrosis, thinning of skin

[45, 46]

Fat transplantation

Autologous alternative to the use of dermal fillers, exploiting lipofilling technologies

Autologous material, easy to dose, soft, repeatable procedure

Large volumes need multiple procedures, larger volumes lacking stability and persistence of shape

[47]