Reccurent Foreign body Granuloma after Gore-tex(R) Removal in Rhinoplasty.

Kwon, Soon Geun; You, Young Cheun; Yang, Won Yong; Park, Jun; Kang, Sang Yun

Case Report

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2008;35(5):611-614.
Published online September 1, 2008.

Reccurent Foreign body Granuloma after Gore-tex(R) Removal in Rhinoplasty.

Soon Geun Kwon, Young Cheun You, Won Yong Yang, Jun Park, Sang Yun Kang

¹Department of Plastic and Reconstructive Surgery, College of Medicine, Kyung Hee University, Seoul, Korea. psyang@khmc.or.kr
²Art Plastic Surgery Clinic, Seoul, Korea.
³Starline Plastic Surgery Clinic, Seoul, Korea.

Abstract

PURPOSE
Infection, foreign body reaction and decreased volume of implant are common complications after augmentation rhinoplasty with Gore-tex(R) implant. The author experienced two cases of recurrent foreign body granuloma in the patients who underwent Gore-tex(R) removal because of infection after augmentation rhinoplasty. and treated them with complete removal of Gore-tex(R). METHODS: Case 1: A 49 year-old female visited our clinic for recurrent foreign body reaction on nasal dorsum and tip area. The patient underwent augmentation rhinoplasty with Gore-tex(R) 3 years ago and implant was removed due to infection 9 months ago. Excision of the granuloma was performed and a piece of foreign body suspicious to be a Gore-tex(R) implant debris was detected under the subcutaneous pocket. The implant fragments were removed and nasalis muscle rotation flap was performed to cover the lesion. The specimen was proved to be Gore-tex(R) in histological study. Case 2: A 31 year-old-male with recurrent foreign body granuloma on the nasal tip area visited our clinic. 10 years ago, the patient had augmentation rhinoplasty with silicone implant and then, he underwent revisional rhinoplasty five times including nasal implant removal, which was performed 9 months ago. The authors excised the granuloma and found a small sized foreign body suspicious to be a Gore-tex(R) implant debris under the granuloma. The foreign body was excised and identified to be Gore-tex(R) in histological study.
RESULTS
In both cases, the lesions were healed without any complications and there were no evidences of recurrence up to 6 months of follow-up.
CONCLUSION
The Gore-tex(R) is known to be weak against mechanical force. These properties of Gore-tex(R) make it difficult to remove the implant completely. In the patient who have infection after augmentation rhinoplasty with Gore-tex(R), the operator should take care to perform the complete removal without remaining fragment of the implant.

Keywords: Foreign body granuloma; Gore-tex(R)