Patient's septal cartilage is best implant material
The best nose bridge implant material placed inside the bridge to augment the nasal bones is the patient’s own natural cartilage from the internal portion of the septum. This will give very long-lasting, stable structural support that feels natural.
Hi, this is a tough problem and every surgeon has his or her own opinion on what is best. Most of us prefer to use the patient's own cartilage if it is available. Other implants include silicone and Gortex which are both man-made and permanent. I personally only use these if I have no other choice and if the patient's skin is thick enough to reduce the risk of extrusion of the implant. I would recommend seeing a rhinoplasty surgeon with experience with revision rhinoplasty. Good luck, /nsn.
Man Made Material for Nasal Augmentation
I do not use man made material for nasal augmentation. I prefer the patient's own cartilage which will become incorporated into their surrounding tissue. Unfortunately, you are an example of the problems that can occur with alloplastic material.
Rhinoplasty, What is the Best Man Made Material for Nasal Bridge Implantation
Since you are asking for the best man-made material to be used as a nasal implant, I will assume that you do not have any of your own nasal septal or ear cartilage available.
I have used both Medpor (made by Porex, see web link below) and Gortex in the past in less than a handful of patients. They all have done very well without warping, infection, or the need for removal. The aesthetic results are very good, but not perfect.
The other alternative is your own rib cartilage, but even the best hands it may warp as well.
Good luck and be well.
The best nasal implant is your own natural tissue
There are many type of tissue substitutes used for lifting the nasal bridge such as solid silicone, medpor, as well others. From the surgeons standpoint, it is nice to feel that there is something 'off the shelf' which has little potential for future troubles. Implants can cause thinning of the skin, stiffness, late infection, and become visible over time. It is for these reasons most rhinoplasty surgeons will use natural tissues from within the nose, ear, or elsewhere to provide the shape and support needed for the nasal bridge and tip. Despite the increased effort nothing will do better over time than the 'real thing'. Implants are reserved as a last resort by many nasal surgeons.
Best of luck,
Stable nose bridge implants
There are many options to augment a nasal bridge, each with its pros and cons. There is no perfect solution.
1. Cartilage: septal cartilage is ideal when sufficient cartilage is available. This is not always the case in revision cases. Ear cartilage tends to warp as well as resorb.
2. Rib cartilage works well but can warp and there is more donor site morbidity/downtime.
3. Alloplast implants i.e. medpore, gortex, silastic work well but have a higher risk of infection and potential extrusion in the future. These are very popular because they are readily available and easy to use.
Your surgeon will assess your particular need and determine which implant is best suited for your nose.
As mentioned there are several "non-warping" implants on the market, they include gortex and silicone implants (medipore is also available but I do not recommend its use) as well as some others.
It's also very important to make a precise pocket in the right plane for an implant to be stable. It should also be sutured to the tissue underneath it so it doesn't move.
So the choice of implant is only part of the story; the implant must be placed in the right tissue plane in order to prevent it from moving.
I use a silastic custom carved implant I call the SLUPimplant.
Medpor is possibly the most stable long term implant with least capacity for long term warping. However, if infected or if you desire removal, it can be quite difficult and cause other problems. Without a doubt the best implant is your own tissue.
EPTFE Nasal Implants have a favorable safety profile.
If bridge augmentation is all you want to achieve, a Non-Surgical Rhinoplasty using Injectable Fillers is likely your best option. I'm experienced in the proper use of Silikon-1000, and bridge augmentation is performed painlessly with topical anesthetic in my office. This may be helpful in camouflaging your "warped" implant, but I'd need to see your full-face photos to be sure.
I've had excellent, natural results with ePTFE (formerly Gore-Tex, now from Surgiform), dorsal implants. The rate of extrusion is less than 5%, and ePTFE does not warp.
I hope this is helpful for you.
I've atttached a photo of ePTFE for your perusal.
I think that your own nasal or ear cartilage is the best implant materiel. This is always a difficult problem and there is no one answer, but I do not like alloplastic materials.