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Which is Best for Bridge: Goretex Implant Vs. Rib Graft Vs. Ear Graft?

asked 2 years ago by mermaid12 in colorado
Latest answer by William Portuese, MD
Question viewed 1,271 times
Tags: cartilage

I went to a doctor for rhinoplasty- he told me he was just going to refine it a little and take very little off.He said no one would even notice. I did not know he was going to scoop out my bridge and take my tip off my nose- now I have an upturned- scooped out- short nose-small nose- with nostrils showing,crooked-and does not look like it fits my face. Doctors that I have seen want to use different grafts and I am confused-I hear good and bad about these different graft materials -Please help,Thank you

14 answers to Which is Best for Bridge: Goretex Implant Vs. Rib Graft Vs. Ear Graft?

Graft Materials for Revision Rhinoplasty

I have used Gortex during the past 35 years of rhinoplasty surgery. However, in revision surgery I use the patient's own tissue;in order of preference the septum, ear, or rib cartilage . The choice really depends on the quantity needed.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon

www.bevhills.com

Implant and graft options for nasal bridge

I am sorry to hear you had such a difficult time with your first rhinoplasty. It is important to go to a rhinoplasty surgeon who is well versed with revision rhinoplasty. There are several different grafts available for reconstructing the nose. Stay away from Gortex implants in the nose since they have a propensity to get infected and we have seen many problems from those implants. The best option is a septal cartilage graft provided there is septal cartilage still left inside your... more

William Portuese, MD
Seattle Facial Plastic Surgeon

www.seattlefacial.com

Nasal Implants for Nasal Augmentation

Hi, There are different implants for different types of augmentation. There is no one best augmentation material. It all depends on how much needs to be augmented and how much experience the surgeon has with that particular material. Don't get caught up with what type of material is used, rather find a surgeon you think can do the job and go with the material he suggests. All of the augmentation material have pros and cons. Keep doing your research and you will find a surgeon that you trust... more

Oleh Slupchynskyj, MD
New York Facial Plastic Surgeon

www.facechange.org

What graft to use depends

Your situation is difficult. Without seeing photos of you it is hard to guess how much work is involved in correcting your problem. Usually in cases like yours there is a significant loss of supporting cartilage, that is why the tip turns up. In that case you will need cartilage to repair and rebuild the bridge of your nose. Gortex has no strength so it is not a good choice for a structural rebuild. Ear cartilage is fairly short and doesn't have the stiffness needed to push the tip back... more

Ivan Wayne, MD
Oklahoma City Facial Plastic Surgeon

Dorsal grafts in rhinoplasty revision.

I feel that any of the materials you mention can work well. I do not like using gortex or any foreign material in revision noses. In 35 years of revision rhinoplasty, I have used septal and ear cartilage. It is your own material and does not have the pain associated with rib grafts.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon

Grafts in rhinoplasty

Every surgeon has his or her own preference for graft material in the nose, so you'll probably read some different opinions on this. I personally like to use septum if it is available and will provide enough volume. In Asian patients, a Goretex or silastic implant is often necessary. I do not like to use synthetic grafts in Caucasian patients given their relatively thin skin. I reserve rib cartilage for patients who need a large amount on their dorsum, but who are... more

Nina S. Naidu, MD
New York Plastic Surgeon

Revison Rhinoplasty, Grafts, Computer Imaging

Hi Mermaid, Sorry to hear about your rhinoplasty unsatisfactory results. It is so very important that patients and rhinoplasty surgeons communicate in an exact manner before surgery. Many times computer imaging is an excellent tool to clear up any miscommunication about the degree of profile reduction or augmentation. At this point you should consult with a few rhinoplasty revision experts (as well as your original surgeon if you still have faith in his/her work). The type of graft is... more

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon

Goretex is my choice

If over 6 months has passed since your rhinoplasty, I would suggest you consider a graft made of Goretex if your problem is as you describe. This material is easy to obtain and to shape and if is easy to remove if not satisfactory. There are many other dorsal nasal implants materials, but I have had my best results with Goretex.

Sheldon S. Kabaker, MD
Oakland Facial Plastic Surgeon

Please attache pictures

It was not clear how long been since your surgery. Please attache pictures and more information. The redo surgery is more complex and you need to wait at least 12 months before and revision. The graft site depends on the amount of tissue needed.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon

Rib cartilage is best material to use for building up the nasal bridge

Goretex, because it is a foreign body, has a significantly higher complication rate than rib or ear cartilage. Of the two I prefer rib cartilage because it has an abundant source and is easier to shape than ear and more easily carved into a smooth shape as opposed to ear cartilage which is very convoluted and will give an irregular appearance to the bridge when the swelling subsides.

Jack P. Gunter, MD
Dallas Plastic Surgeon

www.rhinoplasty-usa.com

You should see if a Non-Surgical Rhinoplasty might improve your appearance.

I'm sorry that you had an unfavorable Rhinoplasty experience. I have found that Injectable Fillers are wonderful for adding volume to a nasal bridge that is too low, and for lowering nostrils that are too high. I am passionate about Revision Rhinoplasty surgery, but if you could get improvement without the inconvenience of additional surgery, that would be preferable. Feel free to email your photos and a description, and I'll be happy to share my thoughts with you. I hope you find this helpful. more

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon

www.ericmjoseph.com

Revision Nose Surgery - "Best" Dorsal implant goretex vs. rib graft vs. ear graft

The natural instinct of anyone with a substandard result is to immediately have it "fixed". This may often result in a worsening of the result which may make return to normal much harder. At this time, I would not spend as much time pondering the choice of dorsal implants. I would instead spend a lot of time choosing several qualified nose surgeons who like to do revision nose surgery. Fixing your nose is NOT as simple as sticking a graft under the skin and walking away. It may... more

Peter A. Aldea, MD
Memphis Plastic Surgeon

Here are your options

Unfortunately I see patients like you every week in my office. Patients who have had over aggressive reductive rhinoplasty by irresponsible plastic surgeons who do not understand the nose or the limits of their own skills. Its a shame! Safe options for implant material are: Septal cartilage, ear cartilage, your own rib cartilage, frozen or irradiated rib cartilage, temporalis fascia, and alloderm. A combination of cartilage and fascia may be needed for the best results. Stay away from... more

Shervin Naderi, MD
Washington DC Facial Plastic Surgeon

Goretex implant vs. rib graft vs. ear graft

After all the expert answers the one that should impress you is Dr Jack Gunter's from Dallas. He is the true rhinoplasty expert here in the USA. From MIAMI Dr. B