Korean Rhinoplasty - Concerning Nose Bridge Augmentation Material

Optimally, it is better to use your own tissue such as your own septum, ear or even rib cartilage for dorsal augmentation rhinoplasty as this has the best long lasting results. However, silicone is commonly used globally as a dorsal solid silicone implant. If a soft silicone implant is placed just in the dorsum and not in the tip it can be long lasting.

Your question is one of the most common concerns for patients inquiring about augmentation rhinoplasty.  Both silicone and Gore-Tex can be safely used for augmenting the nasal bridge.  Any changes to the tip I would recommend strictly using cartilage grafts. Synthetic materials placed at the tip of the nose tend to have more long-term complications.

This is a common concern in the Asian Rhinoplasty patient. Besides the height of the nasal dorsum, one of the major differences between Asian and Caucasian noses is skin thickness. I think that most North American rhinoplasty surgeons have seen cases of silicone implant infection or extrusion (an implant poking through the skin). I believe the risk of infection, extrusion and complications is higher in thinner skin patients.  So skin thickness is a very important factor that I look at when deciding whether a silicone implant is appropriate - regardless of race.

Using cartilage grafts (solid, crushed or diced ) will reduce these infection risks.  However, they usually provide less augmentation (unless the surgeon uses rib cartilage) and there are risks associated with graft visibility, symmetry and smoothness that are not seen with silicone implants.  However, I have seen silicone implants become encapsulated and/or distorted in a way which makes them visible on the nasal dorsum. 

Various types of implant materials have been used for nasal augmentation. You are right, silicone implants seem to be more commonly used in Asia than in North America. What’s probably more important than the type of implant material is the size of the implant. Too large an implant causing too much stretching of the skin simply will not last. I personally prefer to use Gortex for augmenting the bridge and a patient’s own cartilage for the tip. If you do end up having a silicone implant for the bridge I see no reason for not swimming as long as it has completely healed.

Great question! I have removed silicone and Gortex from the nose in Asians...many of which had their procedure performed abroad. I would recommend using your own tissue.

Specifically , I would recommend a rhino-septoplasty with harvest of both superficial temporal fascia from just above your ear and rib cartilage. The rib and fascia will make a graft of diced cartilage with will augment your radix(bridge) and dorsum and the septal cartilage would be used at the tip. 

Bottom line is, I think it is paramount that you use your own tissue...implants are quick and easy for a nose surgeon to put in, but they are the gift that keeps on giving (infection, malposition, extrusion, etc.)

Aggressive recommendation, but lasting results require preparation and execution.

Hope this helps!

Good luck!

Dr. C

johnconnorsmd.com