Infected Gore-tex Nasal Implant

The infected implant should be removed and replaced with a rib cartilage graft at the same time.  Removal of the implant can be done closed but the rib graft requires open approach.

Typically, the nasal Goretex implant can be removed via an endonasal (closed) approach.  Your surgeon should have the skills to avoid injuring the overlying skin during the removal.  Overall, the removal is relatively straightforward but it depends on the level of scar that has developed around the implant and how big the implant pocket is.  All infection must be cleared prior to reconstructing your nose, and swelling must subside as well.  Six to twelve months is typically a good time to wait.  Being that you already had a bad response to an implant, then cartilage from your own body (rib) would likely be the best material to replace the implant.   Make sure you find a surgeon who is skilled and committed in revision rhinoplasty and rib grafting.  Ask to view many before and after photos.  I would be happy to provide you a comprehensive evaluation.  Good luck!

I read your concern. You should consult a reputable, certified rhinoplasty specialist regarding your situation as soon as possible. You can see a list of local certified specialists at abfprs.org.

You may be a candidate for oral antibiotics and local drainage if you have an abscess. If conservative treatment is not indicated, or if it doesn't help you, you should have your ePTFE implant removed. You would be best served by a rhinoplasty specialist that's removed Gore-Tex before. I've removed ePTFE using a closed rhinoplasty approach: through bilateral inter-carttilaginous incisions. I prefer an open approach for rhinoplasty surgery in general, but removing an implant may be performed transnasally. Removing Gore-Tex has been challenging in my personal experience. There is extensive tissue ingrowth, so it doesn't slip out like a silicone implant might.

All the best to you.

Regards from NJ.

If the Gortex implant is infected it must be removed immediately.  Nothing good will come of leaving an infected implant in place.  Once infected, the implant will only continue to smolder in infection and antibiotics will not cure this problem.  The implant has to be removed.  This can be done either through open or closed rhinoplasty techniques, whichever your rhinoplasty surgeon is the most comfortable with.  

The implant needs to be removed ASAP. It is a simple operation that can be done through internal incision. Once, this is done you should see improvement within days.

It can be a difficult task to take the infected Gortex implan. Because gortex has tissue ingrown into it and the removal may jeoperdise the vascularity. BUT YOU HAVE NO OTHER ALTERNATIVE INFECTED GRAFT SHOULD BE REMOVED, YOU MAY SAVE THE GRAFT WITH ANTIBIOTICS FOR A WHILE BUT THE INFECTION WILL COME BACK.

Infection around the nose and eyes is very serious, and can lead to lateral sinu thronbosis.

See you plastic surgeon ASAP

Hi,

You need to see a good Rhinoplasty Specialist ASAP.  You need long term antibiotics and potentially I.V. antibiotics.  The implant most likely will have to be removed and then the area allowed to heal followed by another surgery 6-12 months later to use cartilage to build the area back up if necessary.  The problem with implants in the nose is that they can become infected even 20 years later. 

I hope that you have been treated already.  These are the principles:

If any nasal infection has not come through the skin, have the implant taken out closed--much less dissection or chance of spreading the infection.

Even if the infection is draining through the skin, I would still limit dissection and remove the implant from the inside.  Then let things heal--probably a year, and get your reconstruction done, unless you have just had enough.  I do not use artificial materials in the nose for exactly this reason.

This type of surgery is very successful but must be done by someone who performs revisionary rhinoplasty often.  Find a surgeon whom you trust and who can show you results of other patients with similar deformities that you like.  Good luck!

It's not difficult to remove the Gore tex infected nasal implant and this should be done, IMHO, ASAP as the infection could spread and create serious health issues.  Please see someone about this immediately.

You do not have much of a choice at this point. If your implant is infected it should be removed as far as the approach it depends on how it was placed initially and the size of the implant.