Rhinoplasty Material for Asian Patient Nose Bridge

For dorsal augmentation: 1. Silicone implant - is a rubbery solid compound, but if it is layed on top of the nasal bones, can only be palpated when you move it around. As far as extrusion (implant coming out through the skin), this is more a problem of caucasian skinned patients. Asians, Hispanics and Darker skin types tolerate these implants well. 2. Porex implants - porous polyethylene implants are great for dorsal augmetation in darker skin types. It fits nicely and doesn't move. If done... more

Silicone is a good option, Alloderm will fade with time. Silicone is the most commonly used. I have a friend that believes in Goretex in the nasal bridge. In my experience, Goretex is hard to make smooth but the mild integration of goretex can help fix it better in the nose. Silicone has the tendency to move a little bit. But fixed well in the nose, the silicone can maintain a solid fixation to the bone. Silicone has the most experience in the nasal bridge over the years and has proven... more

We continue to use a combined graft with cartilage and 2mm gortex sheets.  We have had excellent results with the layered graft with a low extrusion rate. The gortex (or ePTFE) molds and countours well with the natural profile of the nose.  

Hi Christy, Porex nasal implants are excellent for Asian nose augmentation. I would advise against Alloderm as the absorption rate is high.  I prefer Porex implants to sialastic material. Choose your rhinoplasty surgeon carefully.  Good luck and be well. Dr. P

Many Asian patients wish to build up the bridge of the nose, sometimes also hoping to refine the appearance of the tip, or lesson the size of the nostrils. There are many materials which have been used to accomplish the augmentation of the bridge, or "dorsum." Artificial materials offer the advantage of requiring no separate surgical site nor incision. These materials, such as silastic, are very straight and can twist nor resorb over time. The potential downsides include the risk... more

The actual choices for augmentation Rhinoplasty include Med-Por (permanent), Gore-tex (Permanent), Silastic (permanent), Rib (subject to some resorption), and the previously mentioned Alloderm (will absorb over time). Additionally you mentioned augmentation and re-projection of the nasal tip. This can be done with the previously mentioned Silastic implant or with use of your own septal cartilage or rib cartilage. My preference is use of the single Silastic Implant which will augment... more

Christy, You've asked a great question. There are many differences of opinion when it comes to Asian augmentation rhinoplasty. Silicone is a preferred implant material for many surgeons especially in Asia, but we would agree with you that it tends to give a really 'block-ish,' unnatural look and feel. And, like rib, it can feel very hard, not like your natural nose at all. That coupled with the uncommon potential for silicone thinning your skin over time makes us prefer other alternatives... more

The use of implants or grafts for augmenting the dorsum in rhinoplasty is an area of controversy. Traditionally, many surgeons have used preformed silicone implants which do the job nicely, but have the potential for extruding even decades later. Alloderm is a nice material, but it is likely to resorb to some degree and does not provide any support in the tip area. In my opinion and in my practice, the best option for a natural and long lasting result is to use rib cartilage. A small... more