How safe is rhinoplasty with implants?

Question

22 y.o. asian planning to get rhinoplasty for a taller nose and bridge. However, I am still not convinced about the safety of implant whether it be silicone/goretex/etc. The nose has very thin skin and inserting foreign material is bound to have inflammation, resulting in expulsion through nose tip or granuloma formation. I believe it's pretty well-known that breast implants fail due to capsular fibrosis and I'm worried for nose implants. What material is safest even after several years? thanks!

Leonard Lu, MD · Answer

Rhinoplasty
in Asians typically involves augmentation, rather than the “typical” reductive
rhinoplasty done in patients with humps on their nose, for example.The nose can be augmented with filler, fat, implants
(most frequently silicone) or cartilage.I have done many silicone implants and it can be done safely in the
right situation, but you would require evaluation by an experienced rhinoplasty
surgeon, preferably one who sees a fair number of Asian patients.Otherwise cartilage is very safe because it
is from your own body, but requires harvesting a portion of a rib to do this.Thank You for yourInquiry-Dr. Leonard Lu

Andrew Miller, MD · Answer

This is one of those questions where there can be several different answers depending on who you talk to. We like to use Gortex for the grafts because it can be easily custom sculpted to fit exactly what is needed. The Gortex also has tiny holes that allow tissue ingrowth so it really becomes part of you as time goes by, making it look very natural. Having said that, your own cartilage can be used if a big enough straight piece is available. Be sure to see a rhinoplasty specialist to discuss the options.

Larry S. Nichter, MD, MS, FACS · Answer

In my experience, most Asian patients do well with a silicone nasal dorsal implant to build up the bridge of the nose. Alternatives include cartilage grafts or even injection of Radiesse or Voluma, which are temporary but last up to 1-2 years and will give you a good idea of your overall appearance. Most silicone dorsal implants if they are not L-shaped do well over her lifetime and have a low incidence of extrusion.

Donald B. Yoo, MD, FACS · Answer

The absolute safest material for your nose from a lifelong, permanent perspective is tissue from your own body (autologous grafts).  Autologous graft techniques do require specialized expertise, and you will achieve the best results with a rhinoplasty specialist experienced in rib cartilage and ear cartilage grafting techniques.

N. Bill Aydin, MD · Answer

Asian skin is usually thicker than whites. as long as the implant picked is not too big for the skin envelop picked, then it should be fine. In addition, if the alar skin if flaring, narrowing that can elevate the tip and create the allusion is nose is more petite.

Suzanne Kim Doud Galli, MD, PhD, FACS · Answer

Synthetic implants are one option for augmentation in Asian rhinoplasty. If this option does not suit you, discuss alternative with your surgeon. These include cartilage grafts from your body or irradiated ribs.

Steven Wallach, MD · Answer

I am not a big fan of nasal implant because of the risk of infection. I prefer either autologous rib cartilage or irradiated rib cartilage.

Tae Ho Kim, MD · Answer

Using implants for many different purposes are safe but always carries risk.  Breast implants, for example, are much safer if the proper size and shape of the implant is chosen.  This requires a thoughtful surgeon with excellent surgical experience, skill and judgment.  There are plenty of doctors who perform the operation without the proper skill or judgment,.  However, it is difficult for the consumer to know who is good and who is not.  When it comes to using implants in the nose, there is a greater risk of implant infection and extrusion than breast implants, but, in the proper setting, a nasal implant can transform the shape of a nose without the complications that can occur.  It is better to have a conversation with a board certified plastic surgeon who has experience in Asian rhinoplasty, who will hopefully give you the pros and cons.  Then, you will be able to make an informed choice.  If you don't like the idea of a nasal implant, you may want to consider a non-surgical rhinoplasty, using hyaluronic acid fillers.  Good luck!

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Hi,Any type of implant can get infected or have issues. It's not about the material that is used it's more about how the implant is  inserted and the shape of  the implant that will determine  the outcome. Find a surgeon that has a lot of experience in ethnic rhinoplasty. This will be reflected in the amount of before and afters on his website and the ability of the surgeon to give you references.Best,Dr.S.

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