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July 1987

Augmentation Rhinoplasty-Reply

Arch Otolaryngol Head Neck Surg. 1987;113(7):779. doi:10.1001/archotol.1987.01860070093030

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In Reply.—Although Avitene is described as an absorbable topical hemostatic agent, when utilized in the facial region, especially over the dorsum of the nose, the Avitene-blood mixture elicits a response that enables the body to maintain the mixture to the extent that I have delineated in my article. The mechanism of this phenomenon is probably secondary to an initial response of platelet adhesion and aggregation followed by an inflammatory reaction. This response perhaps incites the periosteum or perichondrium over the nasal dorsum to manufacture a fibrotic reaction. The exact mechanism of this interrelationship between the Avitene, the blood products, and the local tissues is now under current investigation, and the percentage of new collagen synthesized is currently under active investigation.

It should be remembered that the nasal dorsum has for many years been called a "privileged site" because it reacts quite spontaneously to cartilage and bone implantation as well

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