Rhinoplasty Woes - Cartilage or Silicone, Open or Closed Rhinoplasty?

I'm having rhinoplasty next week, i was adamant of having rib cartilage and doing closed rhinoplasty surgery. Because I'm an Asian, the doctor insists that i should use silicone and do an open rhinoplasty for better results. I heard tonnes of bad stories about silicone implants as such silicone won't be able to last for a lifetime and needs constant rectification. What should i do ? Listen to the doc's advice or be persistence on cartilage and do a closed rhinoplasty ?

Doctor Answers 9

Cartilage vs. Silicone for rhinoplasty

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I do not use foreign material such as silicone in the nose, as I have witnessed many complications. For an Asian nose with a need for dorsal augmentation, I much prefer the use of rib cartilage. I also much prefer the external approach (some call this the 'open' approach) in these situations. It is far too simplistic to consider just doing an endonasal ('closed') approach and placing a graft on the bridge. These noses often require far more support, which is much more easily accomplished with the external approach. I don't want to second-guess you surgeon, but these are just my own opinion.

Fort Lauderdale Facial Plastic Surgeon
5.0 out of 5 stars 85 reviews

Cartilage or silicone implants in Asian patients.

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Both have pluses and minuses. Silicone can get infected more easily, but thousands are used in Asia each month. Though it is faster and easier to place. i have for 35 years used cartilage from the patients ear or septum along with fascia. I like this better than rib since it is less painful and easier to obtain. I have not had any infection in thousands of noses, but you can have minor irregularities that require a minor "touch-up".

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Rhinoplasty - cartilage vs silicone, open vs closed

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First of all, you should always feel 100% before proceeding with surgery so if you have any doubts or a different plan from your surgeon, you shouldn't rush into surgery.  Every surgeon used different techniques that work for them or that they have the most experience with.  Just make sure your surgeon has the proper training and board certification for your procedure.  In general, I prefer cartilage since I feel the body accepts your own tissues than anything synthetic.  Based on your anatomy, you may not be able to have a closed procedure - but some surgeons prefer closed or open techniques based on what they're used to.  Either way, please make sure you and your surgeon are on the same page before you proceed with surgery.

Dr. Cat Begovic

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Rhinoplasty Woes - Cartilage or Silicone, Open or Closed Rhinoplasty?

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RUN and get other opinions RUN!!!!! You are confused and should not do surgery until you are satisfied with the operative plan. From MIAMI Dr. Darryl j. Blinski, 305 598 0091

Open Rhinoplasty with cartilage grafts is safer in the long run.

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The good news about your own or irradiated cartilage is that your body will grow into if and it will become permanent while silicone implants can become infected and extrude years later. There for I would recommend you find a Board Certified Plastic Surgeon with a good amount of experience with these techniques before deciding to have a silastic implant placed in your nose. 

Carl W. "Rick" Lentz III, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 17 reviews

Please listen to your doctor

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Your surgeon has more experience than you. Your request for the rib cartilage is  based on the information that may not be relevant to you. If you are going to trust your surgeon to operate on you,you need to trust him or her fully and do not micromanage your care. Silicone implants are good option . Rib cartilage is usually used for  reconstruction and complex cases where  there is a lot of scarring.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.7 out of 5 stars 152 reviews

How to reconcile differences in opinion with your surgeon

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Most surgeons will recommend and sometimes insist on what they feel is best for you based upon their personal professional experience. Obviously training and previous outcomes will play a role in how they form that opinion. So, in that context, there is often no correct opinion.

What is more important is to avoid trying to put a square peg in a round hole. Silicone, rib, ear cartilage, and perhaps irradiated rib all have their place in nasal surgery. Each technique has its own nuances in terms of best use. A surgeon that is more comfortable with silicone may be less comfortable with rib or some other material.

Pushing your surgeon to use a different technique is tricky business. It is often better to find a surgeon that agrees with you from the start. Perhaps you should re-think your plan and make sure it is the right one for you.

All the best.

Richard W. Westreich, MD
Manhattan Facial Plastic Surgeon
4.9 out of 5 stars 55 reviews

Silicone versus cartilage

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I am not a big fan of silicone implants for rhinoplasty. I prefer rib cartilage or irradiated cartilage grafts.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Silicone or Rib Cartilage - Open vs Closed.

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Surgeons will usually recommend techniques and implants that they feel comfortable using. More importantly, do you like the work the surgeon has shown you, did you speak to any of his/her patients. If you like his/her work and are comfortable that you will get the results you want then go with the advice of the surgeon.
Personally, I like to use custom carved silicone implants with an open rhinoplasty technique. If a custom carved silicone implant is used as opposed to the preformed ones that push on the tip, then they will last a lifetime. You can check out my website below and see some custom carved silicone implants.
Remember, look at the work and talk to some patients.

Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 285 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.