Gore-Tex infection 8 years after original rhino. Would removal be hard? Can ear cartilage be added?

The first thing that I would do is seek the care of an experienced rhinoplasty surgeon or your prior surgeon and get placed on antibiotics.  Often times this may be all that is needed to address a small infection 8 years after implant placement.  If the infection does not clear, Gortex is not terribly difficult to remove if necessary.  Implants like Medpor are far more tricky.  The more important question of whether to reconstruct at the time of graft removal with rib, septal, or auricular cartilage is a more difficult one.  I have had good success with immediate reconstruction without infection of the natural tissue but some may advocate for waiting until the infection clears but that can result in scarring and tissue contracture which does not stretch readily even with grafts.  

It can be challenging to remove goretex though it is very doable.  When infected it is usually easier to take out as it sometimes becomes separated from the surrounding tissue.If there is an active infection you should certainly wait for another time to put in a new graft (such as cartilage).Sometimes the initial removal can be done right in the office and then additional treatments later.

I’m sorry to hear that your dorsal nasal implant has a red and tender bump. This is infection till proven otherwise. If you have a localized abscess, oral antibiotics and office drainage may be curative. If conservative therapy doesn’t work, implant removal may be necessary. GoreTex is more difficult to remove than others since it gets tissue ingrowth, but we have done this when necessary endonasally. Hope this helps. Dr Joseph 

although there are always exceptions, chronically infected foreign bodies in ‘contaminated’ environments like the nose are best managed by initial removal/debridement, appropriate antibiotics and then a ‘holiday’ period before definitive reconstruction.... even though the goretex is to be replaced with autologous (your own cartilage) tissue, it will be at risk of persistent infection if placed immediately.... If it were the case that your infection was clinically minor and the cultures grew only low virulence bacteria, a single stage might be considered, but again this is not the ‘ideal.’Good luck

After a careful examination I would culture your nose and immediately start antibiotics. As long as the supposed infection is eliminated the Gortex can be removed, despite being difficult in many cases because of tissue ingrowth, and cartilage grafts placed at the same time. The key is eliminate all infection before reconstruction.