What Are the Pros and Cons of Replacing Silicone Implant with Diced Cartilage Wrapped in Fascia?

I am going to remove my silicone implant of 2mm, and considering to replace it with diced cartilage wrapped in fascia using ear cartilage. First, is the method safe? Does the shape stays the same the entire lifetime? I would like to know any potential complications if there are any and if those potential complications are reasonable to fix.

Doctor Answers 5

Cartilage Graft instead of silicone implant

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  • Nasal implants have been used for many years, but I have encountered a few patients who have found them to be problematic.  They can shift over time, extrude ( work their way out through the incision), or be very firm to the touch.
  • If  your surgeon recommends using your own tissues, then I agree that the fascia-cartilage technique is helpful. I have had great success with it in difficult noses. 
  • There are some drawbacks- mainly the bulk and size of the graft does tend to shrink a little bit over time as the skin contracts over it. It will probably still look good, but a small follow up procedure or injection may eventually be needed.


Good luck!



Cartilages Graft in Rhinoplasty Better Long-Term Solution Than An Implant

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Replacing your silicone nasal implant with diced cartilage would be an excellent choice. Given that you already have an indwelling capsule from the implant, the diced cartilage in its fascial wrap will adapt well to this existing space. In my experience with diced cartilage, I see few if any problems with its use. It will become firm quite quickly and will offer a permanent solution without potential complications, unlike an implant. The only potential issue is enough augmentation and being perfectly smooth, but more cartilage can always be added later if needed. 

Diced catilage for for rhinoplasty

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The idea of using diced cartilage to raise the nasal bridge is not new, and has persisted in several forms with differing materials to 'contain' the small grafts. The diced grafts are attractive when there are no other more sizable or workable grafts available. Problems such as shifting, resorption, irregularities, do make the use of a rib cartilage graft more attractive for most.

Best of luck,


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What Are the Pros and Cons of Replacing Silicone Implant with Diced Cartilage Wrapped in Fascia?

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What Are the Pros and Cons of Replacing Silicone Implant with Diced Cartilage Wrapped in Fascia?

  I just have one comment, why?   I have performed Rhinoplasty and Revision Rhinoplasty for over 20 years and IMHO, a straight (not L shaped) silastic nasal implant is the most reliable way to build up the nasal bridge.  Taking one out to replace it with diced, ear cartilage wrapped in fascia (dead tissue that surely will dissolve) is taking several steps backwards, IMO.  Ear cartilage has a tendency to dissolve prematurely and unevenly when used on the nasal bridge and dicing or crushing makes this happen more quickly IMHO.  Get a second opinion.

Diced cartilage implant

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Using your own cartilage is always preferable to an implant. The diced cartilage wrapped in fascia technique was introduced by Dr. Rollin Daniel from California a number of years ago. He is a highly respected surgeon and reports good safety and longevity as do other surgeons. Despite that the technique is less then 10 years old so truly long term outcomes are as yet unknown.

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
4.8 out of 5 stars 12 reviews

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