The majority of patients with nasal implants and foreign material do not experience any major problems, and some surgeons have had success using them. However, when complications do arise, they can be significant. These include extrusion where the implanted material erodes through the skin, infection, implant visibility and mobility. The potetial risks of using materials such as Medpore far outweigh the benefits in my opinion.
Medpor Implant for Nasal Reconstruction?
I am not a fan of nasal implants and prefer to your the patient's own cartilage. It may seem like more surgery and more scars at the time of surgery and after, but I strongly believe the benefits of the cartilage outweigh the risks.
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Graft is a better solution
We do not recommend a synthetic implant in this type of a nose. The best option for this type of nasal reconstruction would be septal cartilage if there is any left over from your septoplasty. Another good alternative would be ear cartilage. An additional alternative may be a rib graft.
You should see an experienced revision rhinoplasty surgeon. Noses such as yours require a great deal of judgement. I personally do not use implants in revision noses as the risk of infection and rejection are too great. I would rather use cartilage and soft tissue. One can go to both ears to harvest the cartilage needed.
Medpor is not my first option
Medpor works well and has low "rejection " rate. The concern with the Medpor is tissue ingrowth and difficulty with future surgery and dimpling of the skin. If the implant can be placed in the deep layer it be ok. The best options are cartlage, bone and silicone implant.
You have a rare case of absorbing bone and cartlilage and I would recommend C.T scan of the nose before surgery.
Medpore for Reconstruction of Saddle Nose
It is interesting to hear that your bone graft reabsorbed. Some patients have this outcome with bone (was it from the skull?), others appear to be doing very well.
In any case, personally, I certainly would prefer cartilage grafts in the nose for their predictability and low risk profile. As you may already know, cartilage from the ear(s) or rib are the most likely sources in revision/reconstructive nasal work.
Some surgeons still like irradiated cadaver rib cartilage. Absorption rate may be a little higher but still low.
Artificial implant options may include Medpore or Goretex. Main risks are infections and implant extrusion. Extrusion risk may be higher with Medpore therefore, Goretex may be my very personal favorite of the 2 choices. Infections can happen even years later and almost always require removal of the implant.
I would talk to your surgeon about his experience with Medpore. He may have used it in many cases with low risks. Reports of zero problems would make me wonder...