Risk of replacing gore tex nasal implant after a soft-tissue reaction? (Photo)

Question

I had a rhino 3 years ago; for 2 years, the results were beautiful (see 1st 2 pictures), then I developed a reaction. After the implant was removed, I had to undergo another surgery to remove a remaining seroma and correct the structure (6 months ago). Now, I lack height between my eyes and do not like the angle of my nose, among other things. I am a 4th year med student and lack the time and funds to undergo another operation. My dr. is willing to replace the graft with a new one in the office.

Manish H. Shah, MD, FACS · Answer

Hello birdo1030,Thanks for your question.  The reality with alloplastic nasal implants are that they are foreign bodies that the nasal surgical bed has to deal with over time.  Placing another implant just means that you will have a risk of another reaction in the future.  Goretex as a material for the nose has it's problems.  By Goretex, do you mean Gore-tex, or do you mean porous ePTFE (Medpor)?  They are different but made of a similar substance.  Goretex is a smooth implant but Medpor implants are rough/pourous.  Medpor implants allow for tissue ingrowth which tends to lead to less reactivity.  Goretex implants and silicone implants will encapsulate.  If you get capsular contracture, you would not replace these implants with similar implants.  The problem with Medpor implants are that they are quite stiff.  Have you considered DCF grafts (diced cartilage/fascia grafts)?  They do a great job of creating healthy dorsal augmentation and they are made entirely of your own tissues.If money is a significant problem and you can't wait until a later time for surgical options, you always have the option of non-surgical rhinoplasty using injectible filler material like Juvederm, Restylane, or Radiesse to create a smoother, raised dorsum and radix area.  Speak to your rhinoplasty surgeon about these concepts so that you can make the best decision for now and the future.Good luck,Dr. Shah

Jay Calvert, MD, FACS · Answer

I recommend getting away from the implants and use your own tissue - autogenous rib or ear cartilage if septum is not available.  Dice up the cartilage and wrap it in fascia and create a nice dorsum out of your own tissue.

Risk of replacing gore tex nasal implant after a soft-tissue reaction? (Photo)

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Risk of replacing gore tex nasal implant after a soft-tissue reaction? (Photo)

Answers (2)

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Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.