L Shaped Silicone Vs Gore-tex? I'm at a Dilemma.

       There is not a right answer with regard to the placement of a silicone implant or diced cartilage.  Each has its own problems, and I let patients make the decision.  Find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties and rhinoplasty revisions each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.
Kenneth Hughes, MD Los Angeles, CA

A couple of months ago I removed an L-shaped silicone nasal implant that the patient had placed in Manila about 10 years ago. She had a filler injected more recently and that infected her implant which had to be removed because it was causing the nasal skin to peel. It would have extruded through the nose if left in place.
I think that says it all.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship in order to know if this assessment is valid.

I think that rib graft either your own or irradiated may be better than the synthetic implants. Good luck.

I would not recommend using either a silicone or goretex implant.  Unfortunately, I have had to revise many Asian noses that look unnatural from these implants.  It is always best to use your own tissue/cartilage to obtain a natural appearing result.  I'm not sure what you mean by saying this tissue is biodegradable but it does not usually resorb with time.  Please consult with a specialist in Asian Rhinoplasty who can assist you with achieving the results you seek and can help you visualize your results using 3-d computer imaging.

If you have thin skin, either option is going to be problematic over the long term. I would recommend you see a surgeon who is highly skilled in the use of what is called a diced cartilage graft. It is your rib cartilage, wrapped in a thick layer of fascia from the temple area rolled up like a soft burrito and place under the skin. It is much more natural and will not resorb over time. It has a much softer and natural quality and the shape can be accurately adjusted. I have done this for patients who had bad things placed over the top of their nose and it is much better. Caution however this technique is only for EXPERIENCED surgeons who are comfortable with removing rib cartilage.