Does Silastic Implant for Rhinoplasty Look More Fake Than Cartilage?

You ask very good questions. Silastic and silicone implants carry with them a risk for extrusion and exposure with rhinoplasties. They may look natural, but using your rib cartilage would also look natural without the high risk of exposure. The incision to remove the rib may not be as noticeable as you would expect. Therefore, take into accout all of the risks and benefits of each choice before making your final decision. Good luck!

I find it very difficult to believe you do not have enough cartilage on your ears (plural) and/or septum. If your deficit is that large, it is most likely you will need a substantial graft which is traditionally your rib (hip bone and skull have also been used).
The size of comparable silicone or PTFE (gortex) or polypropylene (medpor) implants to achieve a comparable augmentation would most likely make it more prone to complications, either visibility or rotation, encalpsulation, extrusion, body erosion, etc. Silicone is probably the most coomonly used material and therefore it s complications are frequently described. It is not likely to be permanent. The search for the perfect implant has gone on for over a 100 years. People have even used ivory. However, the perfect implant has not been found. Implants which are the "rage" today may not prove to be ideal in the future as complications arise.