Cartilage or Implants for Rhinoplasty?

Question

Hi, I am thinking about getting rhinoplasty. Can you tell me more about cartilage & silicone implants? Is one more expensive than the other? I think I have plenty of cartilage in my nose to get a bridge augmentation, but what do you think from my photos? What is the lowest age that people can get cartilage implants safely?

Steven J. Pearlman, MD, FACS · Answer

There are a number of factors that determine what a surgeon chooses to raise up the bridge (or dorsum) of the nose. Cartilage from your septum may work. Other choices are solid silicone (I personally never use this), Gortex (i use this sometimes). A wonderful procedure that is getting more popular is dicing up your own cartilage from your septum and from a hidden part of your ear and wrapping it in what is called fascia (natural tissue of your own as well).
	You should see a rhinoplasty specialist to discuss the options for rhinoplasty and augmentation to see what is best for you. Nothing beats a personal exam.

Peyman Solieman, MD · Answer

Dear Missglamour842,

	 

	Unfortunately your picture did not upload but in general we tell patients not to make decisions regarding their face and especially their nose based on the cost difference. You really should look for a surgeon who specializes in rhinoplasty and have a discussion in depth with them regarding the risks and benefits of all your options and exactly what they would recommend and do for you.

	 

	In our own practice we find computer imaging is a great resource in making sure that we are on the same page with our patients and that we understand exactly what their goals are.

	 

	As for your specific questions, we generally tell women that from a physical standpoint they can have surgery as early as 2-3 years after they start their menstrual cycle. However, you also want to make sure that the patient is mature enough to both undergo surgery as well as to understand what the goals of surgery are, ie do they really know how they want to look. As for silicone vs your own cartilage, whenever possible in every surgery most rhinoplasty surgeons would agree that your own tissues are best.

	 

	Regards,

	Peyman Solieman, MD

Stuart H. Bentkover, MD (retired) · Answer

Silicone implants are not commonly used in rhinoplasty in this country. If you need an increase in profile height, most surgeons would usually prefer to use your own cartilage for grafting. As long as you have stopped growing, you can have cartilage grafts. Unfortunately your photos did not show up so I cannot comment specifically on your needs. Silicone, like any artificial implant, is prone to infection. Happy to see you if you wish.

Joseph Rucker, MD, FACS (retired) · Answer

In my opinion cartilage is the best choice for bridge augmentation in Rhinoplasty. My reasons for utilizing this approach are:

	
		the cost of using cartilage is usually less than when using a silicone implant
	
		less of a complication with the possible extrusion of the silicone implant
	
		less of a potential problem with infection
	
		using ones own tissue is much better that using a synthetic implant
	
		some states require the patient to be 18 or older in order to receive a silicone implant

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Hi,

I wouldn't worry about the cost too much it shouldn't change the price of the surgery.

Custom carved silicone implants have the volume and exact shape to fit your nasal bridge. Cartilage grafts can work only if very little elevation is needed.

Best,

Dr.S.

Richard W. Fleming, MD (retired) · Answer

In 35 years of rhinoplasty surgery I've always preferred using the patient's own tissue, their cartilage, to augment the bridge because it will become integrated into the surrounding normal tissue. With implants there is always increased risk of implant movement or extrusion as well as infection. You do have adequate cartilage for the procedure which can be done any time after a patient is physically mature, for a lady 14-16 years old.

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