Asian Rhinoplasty - Synthetic or Natural Cartilage?

Is using natural cartilage from the septum or synthetic material better for an Asian Rhinoplasty to correct a low bridge?

Doctor Answers 11

Asian Rhinoplasty - Synthetic or Natural Cartilage?

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For me this is very clear cut - use your own cartilage.  Even thought the Asian nose seems to tolerate implants better, I always prefer to use the patient's own cartilage.

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Gore-Tex implants are great for Asian rhinoplasty

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Thank you for your inquiry. With all of my Asian rhinoplasty patients, I prefer to use 3D Gore-Tex implants for the bridge. It helps create a beautifully contoured, balanced look. Gore-Tex implants are safe, effective, and do not require taking cartilage from other parts of the body (e.g. ear).

Cory Torgerson, MD, PhD, FRCSC
Toronto Facial Plastic Surgeon
4.7 out of 5 stars 170 reviews

Dorsal augmentation material

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I have switched to using all natural tissue for dorsal augmentation several years ago and have seen a dramatic improvement in the results. Synthetic material has too many problems, both short and long term.

Charles S. Lee, MD
Beverly Hills Plastic Surgeon
4.5 out of 5 stars 79 reviews

Synthetic implant or cartilage to augment Asian nasal bridge

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For Asian rhinoplasty a synthetic material such as silastic plastic is preferred.  The implant is placed over the nasal bridge.  This is better augmentation material, as it is much smoother and works much better in the Asian rhinoplasty population than traditional stacked cartilage grafts from the nose.  

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Is using natural cartilage from the septum or synthetic material better if I have an Asian Rhinoplasty to correct my low bridge?

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This is a very common question here that I have answered many times.  I have performed Rhinoplasty for over 20 years and IMHO, the straight silastic dorsal nasal implant is the superior option for building up the nasal bridge.  Septal cartilage is rarely long ebnough and ear, rib or banked cartilages all can dissolve unevenly over the years, IMO.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Cartilage vs Synthetic Material to Augment Asian Nose

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Whenever possible I prefer to use the patient's own cartilage, rather than use synthetic grafts or cartilage from another individual, to augment an Asian nose. There is no risk foreign body reaction and movement of the  cartilage is very rare.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

It might depend on your long-term goals.

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There are multiple ways to raise a low dorsal bridge of the nose.  If you want a temporary correction you can have a non-surgical rhinoplasty with injectable materials such as: hyaluronic acids (Restylane, Juvederm, etc.), Radiesse, or your own fat.  The advantages are a quick recovery, little discomfort, and immediate results.  The disadvantages are contour irregularities, lack of permanence, and more difficulty when converting to a surgical rhinoplasty.  

As far at dorsal implants are concerned, you have several options: synthetic (Goretex, silicone, Medpor) and cartilage (your own vs. cadaveric, cranial bone).  As far as the synthetic implants go, they are a common approach for stable augmentation.  The advantages of synthetic implants are that they do not require a donor site, they can powerfully shape the bridge of the nose, and they rarely warp.  The disadvantages are that they can get infected, they can shift position, and they can develop capsular contracture causing them to create all types of contour irregularities.  Cartilage implants are a wonderful option because they use natural tissues to augment the bridge. The advantages of cartilage implants are that they can integrate nicely into the surrounding tissues, they are rarely rejected, and they feel more natural.  Some disadvantages are that they may require a donor site, they warp with time if they are not stabilized, and they can be reabsorbed causing loss of bridge height.  Cranial bone implants are most often used in reconstructive nose surgery.

In the end, it is the need of the patient that determines the type of implant used.  Speak with an Asian Rhinoplasty specialist board-certified by the American Board of Plastic Surgery and/or the American Board of Facial Plastic and Reconstructive Surgery to see what would work best in your individual case.

Good luck and warmest regards,

Dr. Shah

Manish H. Shah, MD, FACS
Denver Plastic Surgeon
4.8 out of 5 stars 69 reviews

Asian Rhinoplasty - Synthetic or Natural Cartilage?

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Augmenting the bridge using a silicone implant is a popular technique in Asian Rhinoplasty. And synthetic implants can be used safely. However, there is a risk for a late stage infection with silicone and other synthetic materials. Septal cartilage can be a great option provided the patient has adequate septal cartilage for graft placement. It is easy to harvest and has a lower risk of infection than a synthetic material.

Suzanne Kim Doud Galli, MD, PhD, FACS
Washington Facial Plastic Surgeon

Asian rhinoplasty

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My preference for Asian Rhinoplasty  is your own cartilage.  There is less chance for reaction and rejection and other complications.  However, synthetic material (Goretex, silastic, Medpor) can all be used with excellent results.  So, if septal cartilage (from the nose) is enough, stick with that.  If the bridge is too deficient, then we need to decide if rib cartilage or synthetic material  is right for you.

When it comes to rib cartilage, make sure your doctor removes it with a minimal incision technique.

David Alessi, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 18 reviews

EPTFE (GoreTex) may be used during Rhinoplasty Surgery to add height to the bridge of your nose.

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I read your concern:

In my practice, if Rhinoplasty surgery is needed and if there is a low nasal-bridge, I prefer to use a synthetic ePTFE implant. I like the quality of material from Implantech which is similar to GoreTex implants that are no longer available.Whenever you have a foreign body placed in your nose, there is a low risk of infection or extrusion (<5%).

Many surgeons prefer rib cartilage, septal cartilage, or ear cartilage for nasal-bridge augmentation. Nasal irregularities or resorbtion of cartilage may occur when cartilage is used for this purpose. If your nasal-bridge is quite low, you may not have enough nasal-septal cartilage for augmentation, and there would always be a concern about possible problems related to harvesting cartilage from your ear or rib.

If your bridge needs only minor elevation, you may be a candidate for a non-surgical rhinoplasty treatment using Injectable Fillers. My personal preference is to use Silikon-1000, an off-label filler for permanent results.

I hope this is helpful for you.

Dr. Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

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