I have infected gortex eETPF implant. The implant was placed across the bride of my nose due to thin skin and to smooth things out. I’m aware that if any partials are left behind I will continue to face serious infections. Once the gortex “sheet” is removed should it be closely examined to insure the implant is fully intact and no partials are left behind? If so does it get sent to a lab or pathology?
Doctor Answers 8
As stated in the response to your previous question, removal of the Gortex implant and appropriate antibiotic therapy will correct the problem. An MRI should be done to make sure there is no infection of the bone, which would require IV antibiotic treatment. The only lab study would be a culture and sensitivity of the infected tissue.
Infection in nose
removing the implant and treating the infection are your first concerns. It''s unlikely that your doctor won't be able to remove it completely unless your original surgeon put in multiple small pieces which could be hidden in scar tissue. If you are no longer using your original doctor see if you can get your old op report and find out how much was used.
Gortex infected in nose afetr Rhinoplasty
Yes, the surgeon that removes the Gortex from your nose should inspect to be sure, none is left behind. Typically the gortex would come out in a single piece, unless the surgeon placed multiple small pieces during the last Rhjinoplasty. IMHO Gortex has a nasty habit or becoming infected years after it's use and for that reason, I quit using it in the early 1990's and now only use solid silicone implants to augment the nasal bridge.
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When Gore-Tex, ePTFE implants are removed, they are usually completely removed.
I read your concern. ePTFE (Gore-Tex) implants will get significant soft-tissue ingrowth which makes them particularly challenging to remove. The material is quite strong, however, and it is unlikely that your surgeon will leave some behind. It's fairly easy to feel the implant through your thin skin, so a smooth bridge to palpation after removal will typically indicate that there is no residual foreign body.
Good luck with your procedure.
Regards from NJ.
Nasal Infection from gortex
Best to totally remove all the foreign body if possible. Than yes closely observe the healing for a few months. I would obtain a culture and sensitivity + path examination for completeness.
Infection after rhinoplasty
That depends on how the implant is removed and who removes it. The surgeon who placed it is more likely to know if all of it is out when he/she looks at the piece that is removed. If you had a previous open approach and use the same approach it would be easy to see that all of the material has been removed. Sending the piece that is removed to pathology or a lab will not tell you if any material has been left behind. You will have to wait some number of months after the infection clears before you can re-augment the bridge.
My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.
At a minimum, a sample of the gortex should be cultured.
Beyond culturing the implant, nothing will be gained by performing a microscopic examination of the implant. There is no way to tell by examining the sheet if all the material was in fact removed. Because a microscopic examination of the implant adds hundreds of dollars to the cost of pathology services, and it is not likely to be helpful, you and your surgeon my decide to request that the pathologist only grossly examine the implant (basically look at it and describe it but not perform other testing). Especially if you are paying all the costs of this surgery which your insurance company is likely to consider a complication of a cosmetic surgery and possible not covered by your health insurance, this is a reasonable choice and will save money without compromising your care.
Infected Nasal Implant
While it is unfortunate that your implant became infected, the good news is that there is little chance that bits and pieces of GoreTex will be left behind. Your surgeon may also be able to use either temporalis fascia or gel-film sheeting to accomplish the smoothing effect of the GoreTex at the time of your surgery. It is best to discuss this ahead of time.