My nose rejected the silicone implant. How long before I can have another rhinoplasty using goretex?

Thank you for your question.  If you have an ethnic Filipino nose, you likely had dorsal augmentation as well as tip projection with the implant.  Extrusion usually happens somewhere near the tip because of either infection or the implant being too large or too pointy (thus wearing away the overlying skin).  The body doesn't generally just reject it.  I personally don't like gortex in the nose because of the difficulty in removal if it becomes infected or needs re-positioning.  Your options will include revision immediately with rib cartilage or replacement with another implant (silicone or Gortex) after the infection/inflammation has cleared.  Ear cartilage and usually septal cartilage are not enough to provide the amount of increased projection that most Asians are looking to achieve.  If you are looking for just a little raising of the bridge, then I stand corrected.  Each option has its own benefits and drawbacks.  See a rhinoplasty expert to give you detailed information about your options.  All the best!

Hi Sarang456,In my long term practice in Rhinoplasty using silicone implant, I have only seen one case of real silicone rejection and that silicone had long been obsolete (no longer commercially available). Other so-called rejection is mostly caused by infection caused by a pin-point perforation on the implant which is usually not visible in the surgeon's eye, but can actually invite infection, and can mask as silicone rejection. To address your concern however, normally, if there is no infection, the silicone can me removed and replaced by either goretex or cartilage (usually rib cartilage for the bridge). If there is an infection, I usually recommend patients to wait for at least 3 months. 

THis is not an uncommon problem, and I would wait three months before re-inserting anything.  Goretex would not be my choice.  If you want an artificial implant, I would choose Porex, which is lyophilised bone and is incorporated into your tissue.  Otherwise, natural tissue can be taken from a rib or your hip bone (which would leave an incisional scar at the site where the bone or cartilage is harvested.

You should wait several months before revision surgery to allow infection and inflammation to completely resolve.  I would recommend you have a cartilage graft vs another foreign body placed to prevent repeat rejection issues.  This can be done with ear and nasal cartilage or rib if more is needed.  Find a board certified surgeon who does frequent rhinoplasties.  Good luck.  Donald R. Nunn MD  Atlanta Plastic Surgeon