Is There a Rhinoplasty Procedure That Can Augment the Tip Quite Significantly Without the Risk of Extrusion?

I recently talked to a plastic surgeon in my city and he told me that he takes extra precaution when clients ask for tip augmentation rhinoplasty because of the risk of extrusion through the skin. He told me he only augments tips minimally so that the extrusion risk is minimized. He also prefers to use Medpor for augmentation. I was wondering, however, if there is any procedure where the tip of the nose can be projected quite significantly without the risk of extrusion. Thanks.

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10 Doctor Answers | Asked by romanceex

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Tip Rhinoplasty to Avoid Extrusion of Nasal Implant

The best method to avoid extrusion of a nasal implant with rhinoplasty to the avoid the implant all together. Nasal implants are typically made of silicone, goretex, or other polymers. Implants placed around the tip are more likely to push out of the skin or extrude, as compared to implants on the bridge only. Tip rhinoplasty may be performed by avoiding a nasal implant. Nasal tip cartilage is strengthened and refined with a variety of techniques, which includes cartilage grafting.... more

Is There a Rhinoplasty Procedure That Can Augment the Tip Quite Significantly Without the Risk of Extrusion?

I have performed rhinoplasty for over 20 years and IMHO, I'm just not sure why the plastic and cosmetic surgeon, you spoke with, was so worried about skin extrusion when augmenting the nasal tip. The best method that I have found to reliably and safely, I might add, of creating augmentation to the nasal tip is a cochal cartilage ear graft. It's soft yet strong enough to provide tip definition and support and unlike rib cartilage/bone it doesn't dissolve unevenly over... more

Extrusion risks for nasal tip augmentation are low when using one's own cartilage

The extrusion rate for tip augmentation is significant when artificial materials are employed such as Medpore or silicone. When your own cartilage is employed, this risk is very minimal. You definitely should seek out another opinion for your nose with another board certified plastic surgeon.

Augmenting the nasal tip is best done with your own tissue.

Augmenting the nasal tip is best done with your own tissue. You can increase the tip projection as much as you want and even overproject it if you wanted to do this.

Toby Mayer, MD

7 reviews

Beverly Hills Facial Plastic Surgeon

www.bevhills.com

Rhinoplasty and Tip Augmentation

Hello Romanceex, Implants in the nose are a controversial subject among plastic surgeons and facial plastic surgeons because of their higher risk for infection, malposition and extrusion compared to cartilage grafts. A general consensus is that implants are relatively safe in the bridge area, though. As for tip augmentation, the vast majority of qualified rhinoplastic surgeons would agree that foreign material like implants should be avoided because of an even... more

Natural materials have least risk in rhinoplasty

You will see from multiple comments that natural cartilage grafts have the least problems and are the preferred material for most during rhinoplasty. Cartilage grafts will not extrude, and infection is very uncommon. If you have found a surgeon who only uses Medpor for augmenting the nasal tip you may wish to have another opinion. Best of luck, peterejohnsonmd

Tip augmentation

I think the best and safetest material to use is your septal cartilage. Also, ther ar procedures that advance the medial cruse giving more projection. You need other opinions

David A. Bray, Sr., MD

6 reviews

Los Angeles Facial Plastic Surgeon

drbray.com

Nose shape: Natural tip suppor is better

Increasing nose tip support and definition is best done using the available "resources" within the structure of the nose itself, by suture techniques and rearrangements. When this is not enough, best alternatives include: Ear cartilage. Excellent shaping to the nose tip can be achieved using small grafts from the back of the ears. Donor sites are minimal and very well tolerated Rib cartilage. More involved procurement procedure and more... more

Nasal tip augmentation

My recommendation, custom, and practice, is to avoid alloplastic materials such as silicone and porous polyethylene for isolated nasal tip augmentation. The use of suture technique on the lower lateral cartilages, cartilage tip grafts (single or stacked), advancement of the lower lateral cartilages via columellar strut graft and/or septal to medial crural sutures all eliminate the risk of extrusion.