Rhinoplasty: Q&A
Ask a QuestionCartilage for Bridge Augmentation?
I just went to Asia for rhinoplasty & contacted a lot of board certified plastic surgeons there but they all wanted to use silicone & said they did not use cartilage for the bridge, only the tip. That made me confused. Cartilage can be used for the bridge, right? If septal cartilage can be used to augment the bridge, then would it feel weird in a way? I'm a bit worried because cartilage is softer than bone...? Wouldn't my nose bridge feel softer? Please help clarify, thanks.
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11 Doctor Answers |
Asked by
missglamour842
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Cartilage for nasal bridge augmentation
Cartilage can be used to augment the bridge and the tip of the nose. In Asian patients the amount of augmentation required is rather significant and the septal cartilage is typically thin and insufficient to give the correct augmentation. For that reason, we use silicone implants in the bridge but use cartilage grafts in the tip.
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Cartilage for Nasal Augmentation
Asian Rhinoplasty – Globally, the most common used augmentation material is silicone implant. It is a reasonable procedure and if done properly can be long-lasting. However, in the U.S.A. and in my Asian patients, I only use autologous tissue in the septum such as ear or rib cartilage as this provides a more natural, long-lasting effect. It does, however, require more expertise and experience in shaping and positioning of the dorsal graft.
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Dorsal augmentation may be done with cartilage grafts, medical implants, or fillers
When treating the nose surgically, most surgeons in the U.S. prefer to use the patients own cartilage, either from the septum or the ear. The body accepts it well and the risks for infection are far less than with medical implants like silicone or goretex.
Dorsal augementation can also be done quickly and safely in the office non-surgically using fillers. Non-surgical augmentation of the bridge can be done with Restylane, Perlane, Radiesse, or Artefill. The augmentation...
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A difference in risk and approach
Silicone or PTFE (Teflon or Gore Tex) implants are very common and popular in Asia. The surgery is shorter and often less expensive. In most cases patients do well long term. However, every rhinoplastic surgeon in the US has probably seen the complications. We have all probably seen patients who move here and whose implants get infected. Sometimes it is the result of gentle trauma to the nose and sometimes a sinus infection. Sometimes there is not clear...
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Cartilage for bridge augmentation is an option if....?
Thanks you for your question. Your concerns are commonly heard in my practice. Asian rhinoplasty typically involves augmentation of the tip and bridge. Because the required augmentation for most prospective Asian patients is significant relying solely on septal cartilage is not recommended. To obtain the required mass needed for augmentation options include implants (such as Gore-Tex or silicone) or grafts (rib cartilage). Because both implants and grafts are solid in nature the will...
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Bridge Augmentation in Rhinoplasty With Cartilage
Cartilage from a variety of donor sources can be used to augment the bridge. The use of silicone implants is much easier on both the surgeon and the patient but may have signficant long-term issues. Whether your septal cartilage can be used alone for your bridge augmentation depends on your desired aesthetic result. Silicone implants create a degree of augmentation that septal cartilage can not usually achieve. If your goal is a large dorsal augmentation, you may have to consider rib...
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Cartilage for Nasal Bridge Augmentation
Over the past 35 years I've never use silicone to augment the nasal bridge because of the risk of movement or extrusion of the implant. I always use the patient's own cartilage which will become incorporated into the patient's surrounding tissue. It will look and feel normal.
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Silicone implants for dorsal augmentation versus cartilage
Septal cartilage can certainly be used to augment the bridge, but it typically does not yield enough cartilage to produce a significant augmentation. Surgeons will recommend what they are most comfortable with, and silicone implants are very popular in Asia because they are tolerated fairly well along the dorsum for patients with thicker skin. They are a quick and easy way to build up the bridge. However, they come with an increased risk of complications including infection...
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Cartilage for the dorsum of the nose
I use cartilage for most patients that require dorsal nasal augmentation. It is either harvested from the patient or used from a cadaver.
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Cartilage Grafts for The Asian Nose, Silicone (Silastic) vs Cartilage
Cartilage or silicone can be used to augment the dorsum of the nose. Silicone (silastic) has no real size limitations from the standpoint that you can buy as big a piece as you might want. However, artificial materials in the nose are more prone to complications including extrusion (eroding through the skin or through the interior mucosa and coming out) as well as infection. These problems are more common the bigger the graft.
Either product if done properly should feel...
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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.
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