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

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".

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.

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.

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

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