RESUMO
Objective:To investigate the effect of autologous cartilage and artificial material implants on the occurrence of postoperative complications during rhinoplasty.Methods:This study included 447 patients who underwent cosmetic rhinoplasty at Hanmei Cosmetic Hospital in Dongguan. The age of enrolled patients was 18-52 years, and the mean age was 26.8±6.9 years. They were divided into an autologous cartilage group (334 patients in total) and an artificial material group (113 patients in total) according to the implant material used; the differences in postoperative complications were compared between the two groups and the influencing factors related to the occurrence of complications were analyzed.Results:The follow-up time of all patients was 3-24 months, and the mean time was 19.4 months. 51 (11.4%) of the 447 patients developed postoperative complications during the follow-up period, and the rate of functional failure in the artificial material group (16.8%) was significantly higher than that in the autologous cartilage group (9.6%) (χ 2=4.17, P=0.037). In the autologous cartilage group, the most frequent complications were irregular nasal contour, a total of 10 cases (3.0%), and infection, 8 cases (2.4%); while the most frequent complications in the artificial material group were infection, 6 cases (5.3%) and prosthesis exposure, 3 cases (2.7%). At 2-year follow-up, 32 cases of the postoperative complication rate occurred (16.8%) in the autologous cartilage group, which was significantly higher than that of 19 cases (9.6%) in the artificial material group, and the difference between the two groups was statistically significant (log-rank χ 2=4.37, P=0.039). The results of the multifactorial COX risk factor analysis showed that history of smoking ( HR=1.78, 1.21-2.29, P=0.004), previous history of rhinoplasty ( HR=2.89, 2.08-3.97, P<0.001) and use of artificial materials ( HR=1.34, 1.17-2.08, P=0.013) and external incision (protective factor, HR= 0.92, 0.78-0.98, P=0.037) were independent risk factors for the development of functional complications. Conclusions:Neither the use of autografts nor artificial implants in rhinoplasty prevents the occurrence of complications, and the types of complications occurring in both differ, with artificial grafts having a higher rate of postoperative complications.