While implants lend themselves well for certain plastic surgery procedures, the nose is not the best location for many reasons. Most experienced plastic surgeons have removed more implants than we have placed due to exposure and displacement. They never incorporate into the surrounding tissue as your own tissue will. For this reason we generally prefer to use your own cartilage. The septum inside the nose is often but not always available or sufficient. Using it as a solid graft to lift the bridge often works well but sometimes can warp, shift or show unexpected edges. For this reason I prefer to dice the cartilage and wrap it in a piece of your body's fascia (the temporalis muscle fascia is a good choice when removed from above the ear hidden within the hair). This is referred to as DCIF or diced cartilage in fascia. It can be shaped and molded to the desired contours and has a low complication rate. It completely incorporates into the surrounding tissues and is resistent to reabsorption. This can be accomplished through either open or closed rhinoplasty techniques.
If septal cartilage is available and of good quality is often times used for structural support with a rhinoplasty. From the photograph it looks as though you will need good support of the nasal tip for any significant improvement. Any implant might be necessary.
It's possible to achieve significant and dramatic change using tissue from your own body instead of an implant. To achieve maximal change, rib cartilage will be necessary. The amount of refinement will be limited by the thickness of your skin. Kelly Rowland's nose is perhaps a bit unrealistic because your skin is significantly thicker than hers, but based on your photo, your nose can be made significantly smaller and refined.
To achieve the most significant change, the surgeon is the most important factor as not all rhinoplasties with rib cartilage are created equal.
We have lots of experience with "ethnic" rhinoplasty for patients with thick skin and softer cartilage and we have never used a foreign implant. Depending on the degree of refinement that you are seeking more cartilage may be necessary than can be found in your septum but that is a discussion you can have with the surgeon. The key is a real understanding of thicker skin and an honest analysis and discussion of what can be achieved.
All the best,
Peyman Solieman, MD
African American rhinoplasty without an implant is what I have done for 35 years using the patients own tissue instead of silicone. Your base can be narrowed and your tip refined as well.
An implant is not needed to achieve great results from a rhinoplasty surgery. In fact, implants are associated with complications such as infection, migration, rejection, etc. Having said this, you will need cartilage to achieve dorsal augmentation as well as slimming of your nasal tip and width of the nose. Please consult with a board certified specialist who can assist you with achieving the results you seek. 3-dimensional computer imaging can also help you visualize what you may look like afterwards and serve as an important communication tool with your surgeon.
Thank you for your question, and attached images.
It appears from the close-up images of your nose, and the full face image of your ideal, indicates that you want to add definition to your nasal tip, and enhance your nasal dorsum.
In order to enhance your dorsum an implant of some kind would be necessary.
The variety of implants used for this are essentially of two main categories: Non- self (such as silicone, gortex, etc), or, Autologous tissue (such a rib cartilage, or bone). Although more complex, in that this tissue needs to be harvested, the autologous (your own tissue) is more of the gold-standard.
Either way this would be a complex rhinoplasty, and should be undertaken by a surgeon with a significant experience in augmentation rhinoplasty procedures.
I hope this helps.
S.P. Maggi, MD, FACS
Austin Plastic Surgery Center
A synthetic implant is not required in this type of nasal surgery. To give more height and definition to the bridge line, augmentation with the patient's own cartilage is performed. A tip rhinoplasty can narrow the tip cartilages, osteotomies will narrow the bridge line and nasal bones, and an alar plasty can narrow the nostril base.
Your nose can be improved with cartilage grafts rather than an implant, but the goal may be difficult to achieve given the thickness of the skin envelope.
Kenneth Hughes, MD
Los Angeles, CA
Well, you don't necessarily need an IMPLANT, but you absolutely need AUGMENTATION from something, either implant, cartilage, bone. You have limits to your end result because of the thickness and characteristics of your skin cover. Haveing said that, you can still have a VERY noticeable change with a skilled rhinoplasty.