Autologous tissue and cartilage (your own ear/rib/septum) has a lower rate of infection, extrusion and migration than synthetic implants such as Medpor. Your own tissue provides a safe, permanent result. The downside is that surgery times are longer, since those grafts must be harvested from your body and tailored for your individual nose - as they are not pre-fabricated like synthetic implants.
If Its a Rhinoplasty,which Type is Better? Using Ear/rib/septum Cartilage? but my Doc Wants to Use Something Called Metaphor?
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Implants and grafts for rhinoplasty
We do not recommend Medpor implants to the nose. We always recommend using the patient’s own nasal septal cartilage first. If they have a cartilage depleted nose then ear cartilage would be the best substitute for that. Rib cartilage is only used if the patient is both ear cartilage and nose cartilage depleted. We do not recommend porous synthetic implants in the nose.
Medpor Implants and Rhinoplasty
Any type of implant will have an increased risk of infection over cartilage constructs or cantilever cranial bone graft, depending upon your case. Remember that septal cartilage harvest will not create any additional scars. Ear cartilage harvest will create a scar on your ear, either front or back. Rib cartilage harvest is quite a big deal, producing a longer scar, and risks for pneumothorax cannot be ignored. There is no better here. I do not use implants, but that does not mean it is wrong for you. Discuss your concerns with your plastic surgeon.
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Cartilage graft better than Medpor implant for rhinoplasty.
Implants are easier but have much higher risk of complications in rhinoplasty (extrusion, infection, deviation, etc).
Medpor Nasal Implants Versus Cartilage Grafting
Personally, I prefer to use cartilage grafting from the septum, ear and rib way before I would consider using an implant. This is especially true for Medpor nasal implants. In my experience, this is one of the worst choices for implants when it comes to cosmetic nose reshaping.
Rhinopalsty and grafts
I prefer in most cases to use septla, rib or ear cartilage first for nasal augmentation. I am not a big fan of medpor for the nose.
It is better to use you own tissue/cartilage to build up your nose than implants. I've seen too many problems from others who have had implants placed in their noses (infection, extrusion, movement, etc). Please consult with a board certified specialist who can best assist you in achieving the results you seek.
Medpor or Cartilage for Rhinoplasty
Most experienced Rhinoplasty surgeons will prefer autologous (your own tissue) cartilage to synthetic implants for a variety of reasons. Donor sites for the cartilage can include the nasal septum, ear, and rib. Because of the proximity and ease of harvest in Rhinoplasty, septal cartilage is usually preferable for use. However, the amount of cartilage required or the availability of septal cartilage may require a surgeon to utilize the other mentioned sites. Although Medpor is used for dorsal augmentation, the infection and extrusion rate are much higher than with autologous cartilage, making it a distant fourth choice for use in Rhinoplasty.
If Its a Rhinoplasty,which Type is Better? Using Ear/rib/septum Cartilage? but my Doc Wants to Use Something Called Metaphor
Depend on your nose, it is better autologous tissue, but some time is not enough, and we must find it in septum, ear or rib.
Synthetic materials are more difficult.
There is no "better" option so to say. Each option has pros and cons. You're surgeon is probably referring to a Medpor implant. I am assuming your surgeon wants to use this for dorsal augmentation. I do not like to use such products as they are associated with a significant risk of infection and exposure. These complications can be devastating and quite costly. I personally prefer to use your own tissues as they are much less likely to have such problems. The source of such tissue can be the septum or ear or rib in addition to using TPF. I generally prefer to use septum or ear with TPF. If your surgeon is hoping to dorsally augment your nose, I suggest you discuss options using your own tissues in addition to the Medpor options. Please make sure your surgeon is board certified as a plastic surgeon.
Asif Pirani, MD, FRCS(C)