Anatomical evidence of microbial biofilms in an alloplastic nasal implant

Recently, bacterial biofilms have been proposed as a potential cause of the extreme resistance to antibiotics and impaired host responses in potentially infected facial implants. As opposed to the bacteria in a free-floating or planktonic state, biofilms exist in a sessile form, adherent to a solid or liquid interface and become embedded in a complex matrix that is oftentimes impenetrable to modern day antibiotics. This can lead to chronic infection of implants which ultimately necessitates their removal in a majority of cases. In this novel case report, we show thehis tomorphological appearance of biofilm formation in a patient with an alloplastic nasal implant that was persistently infected and had to be removed. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a fulldescription of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.