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Stephen X. Giunta, MD, Alexandria, Va, recently reported a new semisolid Silastic prosthesis for protrusion of the nasal base. His presentation was at the spring meeting of the American Academy of Facial Plastic and Reconstructive Surgery in Palm Beach, Fla. Dr Giunta classified causes of midface and nasal base retrusion as congenital, racial, or traumatic. He stated that many rhinoplasties must augment the nasal base, including the nasal spine and pyriform areas, in order to achieve adequate tip projection. He further stated that cartilage and soft-tissue augmentations are inadequate and resorb.
A trilobed Silastic implant modified from a chin implant is inserted beneath the periosteum through a midline sublabial incision. This implant lies above the nasal spine with the feet of the medial crura of the lower lateral cartilage lying in a groove. It extends as far lateral as the nasolabial line. Dr Giunta has performed 48 cases in the