Should I remove my goretex implant? (photo)

Question

I got a septo/rhinoplasty done in 2010. I am bothered about the "dent" that is visible due to the implant. I spoke with my surgeon today and he gave me 2 options. Take the implant out and replace it with a L-silicone implant or fully take out the 4 mm of goretex. I am leaning towards taking out my implant. I'm just worried that my nose would look strange if I took out the implant. I don't mind if my bridge is lower if it means that I won't have that dent anymore.Should I seek a second opinion?

Tanveer Janjua, MD · Answer

If you remove the implant which leads to contraction of the soft tissues making it very difficult to augment it again at a later stage.  It is best to use your own cartilage to augment the area. A rib graft or a DCF can work well.RegardsDr. J

David C. Pearson, MD · Answer

In most cases, removal of Gore-Tex implants isn't particularly difficult, even with the modest tissue ingrowth that occurs. When replacing it with cartilage and fascia grafts, it's usually best to do this at the time of removal of the implant rather than at yet another operation. Adequate cartilage may be available from the septum but it can also be obtained from the ear or the rib. I believe that most of us surgeons prefer to use a patient's own tissue rather than a synthetic implant such as Silastic. As for seeking a second opinion, I think that's always wise, especially given the revision nature of your nose.All the best,--DCPPearson Facial Plastic Surgery®

Ira D. Papel, MD · Answer

All synthetic implants carry a risk of infection, extrusion, or worse. This is especially true in secondary, or revision rhinoplasty patients. The Gore-Tex won't be so hard to remove, but a 4 mm. difference in height will be easily noticed. I would recommend using your own cartilage to replace the old implant. Cartilage can be obtained from your septum or the bowl of one ear, cut into small pieces, and then wrapped in fascia (also your own tissue) to make a smooth and natural bridge for your nose. This greatly reduces the risk of infection or having the implant come out later.

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Hi, Since gortex implants have tissue ingrowth similar to medpor, removing the implant may also remove normal tissue further distorting the bridge. Although its possible, Id recommend a custom silione impant rather than a L shaped implant. L shaped implants can look distorted as well and may extrude through the tip.Best,Dr.S

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