Are I-shaped silastic implants a good option? Do they reduce the complications associated with traditional L-shaped implants?

Question

Do I-shaped silastic implants used only on the bridge greatly reduce the complications associated with traditional L-shaped implants? From my research, it seems most of of the problems from silicone implants are due to using L-shaped implants that place undue stress on the skin of the tip. Would using an I-shaped implant to elevate the bridge, and cartilage grafts to increase tip projection and definition a reasonable approach?

Babak Azizzadeh, MD, FACS · Answer

L-shaped implants are used when a surgeon wants to build the bridge of the nose and increase the projection of the tip.  It is usually performed through a closed approach and very quick.  I definitely try to avoid L-shaped silicone implants as they increase the risk of "extrusion" which is exposure of implant through the lining of the nose.  I prefer using the patient's own cartilage for most cases involving augmentation of the bridge and tip support.  It is long-lasting and predictable but it does require expertise on the part of the surgeon and the operating time is usually longer.  The key is to get the best results possible even if it takes a bit more time.

Toby Mayer, MD · Answer

Cartilage vs silicone implants of any type. I have never needed to use silicone in more than 35 years of rhinoplasty since the possibility of infection is much greater than using your own nasal cartilage. It may be necessary to use ear cartilage as well. I have never had an infection using cartilage.

Joseph Mele, MD · Answer

(Link Provided) If an I-shaped implant will provide the type of correction you need, then it is often a better option. You are correct in that most of the complications of the L-strut nasal implants occur at the tip; however, most of these are done for patients requiring more projection at the tip. Often this is associated with tighter skin which may not provide the best coverage for the implant. Cartilage may be a better choice for smaller amounts of augmentation. Best to consult with a Board Certified Plastic Surgeon or Facial Plastic Surgeon who has experience with nasal augmentation. Computer imaging is very helpful for evaluation and preoperative planning.

Kimberly Lee, MD · Answer

In general, I recommend using your own cartilage and soft tissue when building up the bridge instead of using implants.  Implants have additional risks of migration, infection, rejection, extrusion, etc. regardless of being I or L-shaped.  Please consult with a board certified specialist who can assist you with
 achieving the results you seek.  3-dimensional computer imaging can 
also help you visualize what you may look like afterwards and serve as a
 communication tool with your surgeon.

William Portuese, MD · Answer

In our practice, we prefer to use cartilage grafts for  nasal bridge line augmentation with only a few exceptions, such as an Asian nose. We do use Silastic implants along the bridge line that are small wafers called Flowers nasal dorsal implant manufactured by Implantech. We do not use the L-struts due to the complications mentioned above.

Frederic H. Corbin, MD (license restricted) · Answer

You appear to have done you research and yes the. " L" strut is associated with more complications but autologous tissue or rib is preferable to siliconeDr Corbin

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Hi,L- shaped implants tend to put more pressure in the tip making extrusion and infection more likely. However, and I shaped implant can also move or extrude if it is not place properly.Best,Dr.S.

Richard W. Fleming, MD (retired) · Answer

I-Shaped silicone implants are much safer than L-Shaped implants. However, cartilage implants are better than either because you can avoid the increased risk of infection, movement or extrusion with the silicone.

Are I-shaped silastic implants a good option? Do they reduce the complications associated with traditional L-shaped implants?

Answers (8)

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