Own cartilage or Gore-Tex for rhinoplasty?

Question

Some surgeons say Gorotex is also safe and hasn’t had bad reactions plus it heals faster ..., some also claims it can last life time - ??? Need advice What do you think about local anesthesia versus general anesthesia for this procedure?

John Bitner, MD · Answer

While you may be able to find individual stories of patients who have been safely and effectively treated with Gortex, the complication rate is unacceptably high. An infected implant is a disaster! If infected, it needs to be emergently removed and your nose packed open. The scar tissue that develops afterwards is extremely difficult to deal with and your nose will never look right in the end.  The one physician favoring this approach in your question string quoted a 5% chance of infection (I believe that number to be closer to 20% depending on the study used). But, would you accept a 5% chance that you're rhinoplasty will end in disaster? I agree that there are pluses and minuses to every  material available in rhinoplasty. But, the minuses to using foreign material in the nose are so negative that I can not ever recommend it. Explore options using your own material.  You have enough spare parts to do the job.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  I strongly recommend using your own cartilage vs a foreign substance such as gortex, which can result in extrusion, malposition, or infection.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

Eric M. Joseph, MD · Answer

There are innumerable methods of performing rhinoplasty surgery and raising a nasal bridge. My rhinoplasty teacher taught us to use ePTFE (GoreTex). There may be a 5% chance of infection over a lifetime, however, it's easily custom-carved and leads to natural looking bridge elevation in most. Cartilage may warp or become visible through your nasal skin, depending on your examination. Nearly all of our rhinoplasty patients require general anesthetic to protect their lower airways. Hope this helps! Dr Joseph

P. Daniel Ward, MD · Answer

Thank you for your question! This is an important question that has a clear answer. I, and nearly all of my experienced rhinoplasty surgeon friends and colleagues across the country (who perform a lot of revision rhinoplasty procedures), would strongly advise against using any sort of foreign body implant in rhinoplasty. Using your body’s own tissue, such as septal cartilage, ear cartilage, or rib cartilage, is much, much better and safer. Seek out an experienced rhinoplasty surgeon who can help guide you through these decisions.Please let us know if you have any other questions or concerns!

William Portuese, MD · Answer

In our practice, we do not recommend Gore-Tex placed in the nose for a variety of issues that we have seen in our practice over the last 25 years. Always best to use patient's own cartilage when needed for grafting purposes. In our practice, we also place all patients under general anesthesia by a board-certified physician anesthesiologist for patient safety and comfort.

Richard W. Fleming, MD (retired) · Answer

I will not place synthetics in the nose. I have removed too much of this material from noses of patients who came to me for revision rhinoplasty consultation. I use the patients own cartilage. It depends on what will be done during the rhinoplasty operation but I typically use a light general anesthetic administered by my MD anesthesiologist.

Own cartilage or Gore-Tex for rhinoplasty?

Answers (6)

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