What is Alternative to Silicone Implant? Rib Cartilage Safe?

using your own rib (not irradiated rib) is the best and safest long-term option for replacement of a silicone implant - you can also remove the implant and see if you like the look of the bridge without anything

Using your own rib cartilage is a very good alternative to using a silicone implant. Since it's your own tissue there isn't the same issue of rejection that can occur with silicone.

Issues to consider with rib cartilage is that of carving the implant properly to prevent warping. In experienced hands this risk is quite low. A great thing about rib cartilage is the abundant supply of very strong cartilage it provides for any number of nasal problems, including rebuilding the bridge.

Solid Silicone, called Silastic, has been used for many decades to build up the bridge of the nose. Unfortunately, it has a tendency to become infected from months to years later. There are a number of alternatives. Another synthetic is Goretex. Using your own cartilage, such as nasal septum or ear cartilage is also useful.

In my opinion, for a very scooped nose, rib cartilage is the best alternative. It can be used as a solid block or diced and wrapped in a layer of fascia, which is the covering of a muscle from your temple. To get a millimeter or two augmentation, you can dice the cartilage from one ear and wrap it in the fascia for a subtle enhancement of your profile.

I'm not a big fan of silicone (Silastic) in the nose or even Gore-Tex since these can extrude or become chronically infected. It sounds like yours may be in the process of extruding.

Rib cartilage is the next best option especially when a lot of material is required, but even when very little is needed. It does require the creation of a small scar on the right side of the chest and carries with it more initial post-op pain. The graft has to be cut very carefully to avoid later warping, though, which is probably the greatest problem with rib grafts in rhinoplasty. Lately, there has been a resurgence of the use of irradiated cadaver rib cartilage which avoids taking the patient's own rib. Depending on where and how they're used, though, rib grafts can resorb to some degree over time.

All the best,

--David C. Pearson, M.D.

There are many alternatives to augmenting the nasal bridge.  Septal cartilage is always the first and best alternative in augmentation rhinoplasty.  If the nose has been cartilage depleted then attention is directed to ear cartilage for use of auricular cartilage to build up the bridge.  Rib cartilage is an acceptable alternative as well, but is very stiff and tends to warp over time.  The best synthetic implants are silastic implants.