Which is Best for Bridge: Goretex Implant Vs. Rib Graft Vs. Ear Graft?

I would use septal and ear cartilage before rib, and rib cartilage before Goretex.

Kenneth Hughes, MD

Los Angeles, CA

Your situation is difficult. Without seeing photos of you it is hard to guess how much work is involved in correcting your problem. Usually in cases like yours there is a significant loss of supporting cartilage, that is why the tip turns up. In that case you will need cartilage to repair and rebuild the bridge of your nose.
Gortex has no strength so it is not a good choice for a structural rebuild. Ear cartilage is fairly short and doesn't have the stiffness needed to push the tip back down. My number one choice in a case like yours is rib cartilage. I use it rebuild what is missing and try to restore a natural shape. Septal cartilage could be used in a similar fashion if you have any left.
The most important thing for you is find a skilled and experience rhinoplasty surgeon who can handle a case like yours without making it worse. I hope this helps.

I feel that any of the materials you mention can work well. I do not like using gortex or any foreign material in revision noses. In 35 years of revision rhinoplasty, I have used septal and ear cartilage. It is your own material and does not have the pain associated with rib grafts.