I broke my nose as a child. As a result had to have cartilage taken from my ears at the age of 17, and the graft re-absorbed after about a year after Rhinoplasty. I've been back to the surgeon, and he recommends a implant called Permacol. Anyone got any thoughts on this? Thanks.
Permacol for Nasal Implant?
Doctor Answers 8
You will have a permanent solution if you use grafts from yourself than with fillers which are temporary. See a revision rhinoplasty surgeon who has a great deal of experience dealing with noses like yours and let him guide you to the best solution.
You would be surprised how much you can improve a low nasal bridge with Injectable Fillers. If you'd like to email your photos, I'll be happy to share my thoughts with you.
I've attached a link to my Non-Surgical Rhinoplasty photos for your perusal.
I hope this helps, and best regards.
Web reference: http://ericmjoseph.com/index.cfm/ProcedureNameID/731/PageID/4141
Depending on your ethnicity, your nose MAY tolerate some grafts longer than others BUT it is a fact that grafts taken from your body will vastly outlast any and all others.
Permacol is usually used for hernia repairs and is derived from pig skin. There is NO guarantee that it will not absorb.
Other similar solutions such as Alloderm (human skin) also may or may not persist in a scarred bed.
The only plus with using such implants is that your own body is not used as a graft source (IE no donor site morbidity) BUT they cost more and may very well last a lost shorter time.
I agree with the previous post that you should have it done by a reputable nose surgeon who is experienced with redo (revision) nose surgery.
Good Luck.
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That wouldn't be my top choice for a revision rhinoplasty (nose job / nose plastic surgery / nose cosmetic surgery / rino plasty / rhynoplasty). This product will get absorbed and might have a potential for an allergic reaction. The manufacturers state that the implant is eventually replaced with your collagen. I think that this needs to be further proven. My position on new products is that I let others make the mistakes with it first and then I'll use it if it has proven itself over 5-10 years time and has shown a strong safety record.
Because you have had previous implants with your own ear cartilage I would suggest that you might want to think about rib grafts. Cranial bone grafts are an option but they are considered by many to be too firm in the nose and have a variable absorption rate. A rib graft does have a significant commitment associated with it that you would need to accept. An alternative would be a silicone implant that is a better option with your first surgery but less so the more revisions you have. I wouldn't consider an implant after the first revision. The risks of infection goes up. But possibly for the second revision if you really didn't want a rib graft.
I hope that helps!
Permacol is made from the middle layer (dermis) of skin from a pig. The manufacturers claim it is permanent (resistant to resorption) but that has not been my experience. I have not had extensive experience using it, but the few times I have, I felt it either resorbed or partially resorbed. Grafts from your own body are more reliable in resisting resorbtion although you said the ear cartilage did resorb. Either septal cartilage from inside your nose or cartilage from one of your ribs would be more likely to be permanent.
Permacol is a pig collagen and can get absorbed over time. This means after a certain time you might lose the improvement in the shape of your nose.
The most important thing for you to answer is if the shape of your nose bothers you and how much. If it is only minor deformity then you are better off not doing any surgery. The risk of revision surgery is high. If you still want to proceed then the best bet is your own tissues. If the nasal septum cartilage and ear cartilage is not available then rib cartilage can be used.
Regards
Web reference: http://www.janjuafacialsurgery.com
Dear Gaz.
If you have already had several operations on your nose you do have a significant amount of scarring inside. My first recommendation is to see a plastic surgeon with a good deal of experience in dealing with secondary (or redo) rhinoplasty. Personally, I try to use your own tissue whenever possible including cranial bone grafts from the skull or rib cartilage grafts if needed.
Go on several consultation before making a final decision.
Steven Schuster MD FACS
Nasal implants are not a great idea unless all the cartilage in the nose and the ears has been exhausted. If those have been exhausted, a rib cartilage graft is an option. Silastic implants can also be used, these are inert plastic wafers inserted into the nose to give an augmentation. All cartilage needs to be used prior to embarking on a synthetic implant.
Web reference: http://www.seattlefacial.com
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.
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