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Autoalloplast. An experimental and clinical study.

The concept of an autoalloplast offers the convenience of an alloplast and the safety and reliability of an autograft. An alloplast that acts as a scaffold for fibrous tissue ingrowth retains many of the characteristics of an autograft when reimplanted. Fibrous encapsulation is essential to the retention of all implanted impermeable synthetic materials. They then retain a potential for extrusion. Polyamide mesh, which allows the ingrowth of fibrous tissue, is a synthetic implant that circumvents the potential for extrusion. The fibrous tissue ingrowth provides substance to the graft, which permits precise carving with a scalpel after the initial implantation into a vascular area. A suitable period is necessary to allow fibrous tissue ingrowth. The incorporated mesh material is then harvested, shaped, and reimplanted into the augmentation site as an autoalloplast. A three-phase animal study to determine the feasibility of the autoalloplast concept is presented. It showed that fibrous incorporation of polyamide mesh occurs, and harvesting and reimplantation were feasible. It also demonstrated the superiority of the autoalloplast to withstand trauma without extrusion when compared with autogenous cartilage, polyamide mesh without fibrous assimilation, and Silastic. Since 1974, twenty-one humans have received successful implants with the autoalloplast. The patients have been followed up for two to 7 1/2 years, with all cases successful to date. The prospect of nurturing and biologically assimilating an implant in a safe and controlled area of a host and its subsequent reimplantation expands the field of reconstructive surgery and offers a practical method for managing certain facial deformities.