Three-dimensional soft tissue change after paranasal augmentation with porous polyethylene

The aim of this study was to investigate the effect of porous polyethylene (PPE) in paranasal augmentation on midfacial soft tissue architecture. This retrospective study recruited patients with midface retrusion and mandibular prognathism. Twenty adult patients who had undergone bilateral PPE augmentation (ready-made type, thickness 4.5 mm, Medpor) to the piriform aperture and simultaneous mandibular setback surgery were included in this study. The soft tissue morphology and thickness of the midface were evaluated using three-dimensional reformatted images from cone beam computed tomography done before and 6 months after surgery. The soft tissue outline of the midface was augmented 1-4 mm. The average increase in soft tissue outline near the peri-alar region was 3.1-3.4 mm, which comprised 68-74% of the PPE thickness (P < 0.01). The nasolabial angle and columellar inclination were increased significantly (2.2 degrees and 1.4 degrees, respectively; both P < 0.05), whereas the nasal tip angle, nasal tip protrusion, columellar length, and bilateral nostril axis angle did not change. The alar base became wider on average by 2.2 mm (P < 0.01). The results showed that paranasal augmentation with PPE significantly increased the overlying soft tissue outline without influencing the nasal projection and could enhance paranasal aesthetics with minimal morbidity.