Should I remove 14 year old gortex implant if I pursue alar base reduction and tip refinement? (photos)

Gortex implant to raised height of nose and tip refined at age 16 in Korea. The length of the implant may be too short (I have a line/dip at the top.) I am wondering if the implant is now crooked or creating a too strong appearance at the edges. Also, nose is still bulbous due to fat/skin and nostrils are wide when I smile. I would like to correct these issues and am wondering if the gortex should be replaced with cartilage? Would my face be better balanced with a small chin implant as well?

Doctor Answers 3

Removal of Gortex Implant, Improving Tip Definition, and Narrowing Nasal Base

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Your tip definition can be improved and your nasal base narrowed to improve tip refinement. If the Gortex implant is remove because you're concerned about future movement,extrusion, or infection I suggest you consider placement with a diced cartilage/fascia graft to maintain good projection and definition of the bridge. The cartilage can be taken fro the septum or ears.This would avoid the need for a chest incision to harvest rib cartilage

Beverly Hills Facial Plastic Surgeon
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Rhinoplasty revision

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Rhinoplasty revisions often require removal of Gortex grafts and replacement with costal (rib) cartilage grafts. This is done because Gortex will ultimately get loose, infected, and extrude. Good news is that rib grafts are now available as cadaveric (organ donor) grafts so it won't require harvesting your own rib cartilage. A consultation is necessary to provide you details of your surgery.

Dorsal onlay of Gortex

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You do have slight cant of the dorsum from right to left when considering your nose from superior to inferior (top to bottom).  If this is and issue for you consider removal or an attempt at repositioning.  If removed something should be replaced.  Rib cartilage in some form would be the best replacement.  However, and this is a big however, there is the possibility that the replacement process may not make your dorsum straighter.  So if the only thing that bothers you now is tip and alar base you might strongly consider leaving the gortex in place.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.