Revision Rhinoplasty: Q&A

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What is Alternative to Silicone Implant? Rib Cartilage Safe?

Hi, I got my rhinoplasty about a year ago in another country but i have been seeing redness and white color near 2mm is silicone placed in my nose bridge. I am considering to go back for re surgery, I want to take out silicone and replace it with something. What is another SAFE options? I used ear cartilage already for my tip, can i use rib cartilage on my nose bridge? do i even need one since it was 2mm? What is the cons of using rib cartilage on the nose bridge? Thank you!

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12 Doctor Answers | Asked by moving in NY,NY

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Alternative to nasal silicone implant

There are many alternatives to augmenting the nasal bridge. Septal cartilage is always the first and best alternative in augmentation rhinoplasty. If the nose has been cartilage depleted then attention is directed to ear cartilage for use of auricular cartilage to build up the bridge. Rib cartilage is an acceptable alternative as well, but is very stiff and tends to warp over time. The best synthetic implants are silastic implants.

Rib best alternative to silicone implant

Using your own rib (not irradiated rib) is the best and safest long-term option for replacement of a silicone implant - you can also remove the implant and see if you like the look of the bridge without anything

Sam Naficy, MD

80 reviews

Seattle Facial Plastic Surgeon

www.seattleface.com

Replacing silicone nasal implant on bridge

Using your own rib cartilage is a very good alternative to using a silicone implant. Since it's your own tissue there isn't the same issue of rejection that can occur with silicone. Issues to consider with rib cartilage is that of carving the implant properly to prevent warping. In experienced hands this risk is quite low. A great thing about rib cartilage is the abundant supply of very strong cartilage it provides for any number of nasal problems, including rebuilding the bridge. more

Alternative to Silicone Nasal Implantt

It is not an emergency, but I recommend removing the implant in the near future; the white patch you're seeing is the silicone implant under very thin skin. If this extrudes, you'll have to deal with a scar in the nasal skin. You can then consider alternatives to augment your dorsum if that is necessary. This is why I don't recommend silicone implants - I've seen this too many times over the last 35 years.

Richard W. Fleming, MD

9 reviews

Beverly Hills Facial Plastic Surgeon

www.bevhills.com

Rib cartiage

Any procedure carries risks, the goal of the surgeon in conjunction with the patient to balance the relative incidences of the risks with the potential benefits of the procedure. Having said that if your implant is infected , ie red and swollen, it will require removal. The type of augmentation is related to the size of the augmentation . So one of the key factors in your situation would be to determine the height and length of the augmentation.

Rib cartilage is very safe for rhinoplasty and can give you a lifetime solution

Rib cartilage is very safe as long as it is performed by a surgeon who does it frequently. If the surgery heals well, you will have a permanent new nose. The problem with rib cartilage that all surgeons have is that it has strong internal stresses and can sometimes deform after surgery. The chances of that happening depends on patient age: older is better. I perform rib grafts frequently on badly damaged noses but still need to revise about 9% of my cases if the patient wants... more

Rhinoplasty and rib cartilage

It sounds like the silicone implant is under very thin skin. I am not a fan of silicone implants, as there are some very bad complications associated with silicone. I would recommend seeing a revision rhinoplasty specialist for a consultation. They may recommend removing the implant and replacing it with rib cartilage. While I feel that it is a better option, there are still complications associated with rib grafts that you can discuss with your surgeon.

Ryan Greene, MD, PhD

19 reviews

Fort Lauderdale Facial Plastic Surgeon

www.DrRyanGreene.com

Macroplastique for nasal augmentation

It sounds like your implant is about to extrude - which is not uncommon. You should see a plastic surgeon as soon as possible. As an alternative, Macroplastique is a wonderful material for dorsal augmentation. It is placed by injecting and is permanent, like silicone, but does not have the problems that solid implants do. Although FDA approved for injection around the bladder, it has shown great success when used in other areas. Be sure you seek a surgeon with... more

Silicone nasal implant still best

If you have can L-shaped silicone nasalnimplant, they create redness and can even erode through the skin. For those reasons, they have been replaced with straight silicone nasal implants. It's the L section that creates pressure on the skin. When patients come to me with that implant, I trim back and remove the L section which reduces the pressure point on the nasal skin and reshape the tip with a conceal cartilage ear graft. I have performed Rhinoplasty for over 20 years and IMHO, bone,... more

There are a number of alternatives to build up the nasal profile in rhinoplasty

Solid Silicone, called Silastic, has been used for many decades to build up the bridge of the nose. Unfortunately, it has a tendency to become infected from months to years later. There are a number of alternatives. Another synthetic is Goretex. Using your own cartilage, such as nasal septum or ear cartilage is also useful. In my opinion, for a very scooped nose, rib cartilage is the best alternative. It can be used as a solid block or diced and wrapped in a layer of fascia, which... more

Rib grafts for revision rhinoplasty

I'm not a big fan of silicone (Silastic) in the nose or even Gore-Tex since these can extrude or become chronically infected. It sounds like yours may be in the process of extruding. Rib cartilage is the next best option especially when a lot of material is required, but even when very little is needed. It does require the creation of a small scar on the right side of the chest and carries with it more initial post-op pain. The graft has to be cut very carefully to avoid later... more

What is Alternative to Silicone Implant? Rib Cartilage Safe?

There are several alternatives to silicone implants some are synthetic such as Gortex others could be your rib cartilage which causes a scar and is very painful procedure and can warp. . Cranial bone graft can also be used and is less painful ( virtually painless ) but needs to be done by surgeon experience in harvesting this graft. Cadaver rib cartilage is readily available and has been used for over 30 years with good results. I will have to say that I have used silicone implants for 20... more