Dangerous side effects of using PCL mesh for rhinoplasty

Dangerous side effects of using PCL mesh for rhinoplasty

Be careful when selecting new and experimental materials for your nose surgery!

Synthetic materials commonly used for rhinoplasty surgeries include silicone implant, Gore-Tex implant, Medpor, PDS plate and PCL mesh. 

However, JW Clinic’s Dr ManKoon Suh – President of the Korean Academic Association of Rhinoplasty Surgeons – recommends patients to be careful when agreeing to the use of PCL Mesh for their nose surgery. 

There are several reasons why you should be careful of using it.

1. Fibrosis cannot maintain the new position of the nose tip

The current buzz surrounding PCL Mesh is similar to that of Medpor, which is now not recommend for nose-tip surgery on Asian patients because of serious side effects, including skin redness and potential extrusion through the skin.

PCL, or ‘Polycaprolactone’, is a hydrophobic, semi-crystalline polymer with a good flexibility. It is an absorbable mesh which is easy to manipulate and has a slow degradation rate to H20 and CO2, over approximately 3-4 years.

Because of these characteristics, PCL mesh is currently being used as a mechanically and structurally implantable rhinoplasty scaffold.

Some doctors argue that even after absorption of this material in the nose, fibrosis at the absorbed mesh site can help to stabilize the nasal tip in its new, corrected position.

However, Fibrosis cannot maintain the new position of the nose tip, as fibrous tissue is not a stable structural element. Fibrous tissue is not cartilage, and is in fact often regarded to be a main cause of nose-tip drooping due to its contractile force.

2. PCL mesh can erode the septal cartilage

Another problem is that PCL mesh can be exposed through the septal mucosa.

Exposed PCL mesh (A)  
Exposed PCL mesh (B) 

In addition, like all foreign materials implanted into the body, PCL Mesh can be prone to infection.

Most importantly, PCL mesh can erode the septal cartilage, weakening the septal structure.
This is especially true when PLC mesh is placed on both sides of the septum as a septal extension graft. In this case, the thickness of the septal cartilage decreases, causing a loss of structural stability. because of the diffusion impairment of nutrition from septal mucosa and it can be the cause of septal weakness.
thinned septal cartilage

As the mesh absorbs completely, the weakened septum may cause remaining septal cartilage to collapse, resulting in a disastrous saddle-nose deformity.

Dr. Suh suggests that more time and experience is required to confirm the safety of PCL mesh during rhinoplasty, adding that its future does not seem to be bright.

Don’t be one of the early, trial patients for whom PCL Mesh is used! 

There are plenty of materials that have been adequately tried and tested for safety that can be used for your rhinoplasty.

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