Do Rib Cartilage Implants Have to Be Replaced or Revised After a Few Years of Use, Like Silicone and Goretex Implants?

I understand and have heard that silicone, goretex and all other synthetic implants for rhinoplasty will eventually have to be replaced (or revised) after years of wear and tear. From this forum I have heard many surgeons recommending that the best material used for rhinoplasty is our own autologous tissue such as rib cartilage or septal cartilage. I would like to know if autologous tissue used for rhinoplasty will eventually require replacement or revision too?

Doctor Answers 8

Cartilage vs Synthetic Implants for Rhinoplasty

While every nasal implant material has its own set of unique problems, wearing out or the need to be replaced is not one of  them for any of the materials. The nose is not a place where any graft material is exposed to 'wear and tear' that would cause resorption or weakening of the materials. The concept of replacement or revision of any nasal implant can occur with any material, synthetic or cartilage, due to cosmetic concerns such as  shape or shifting and infection. While I am a big fan of autologous cartilage whose risks of infection and extrusion are very low compared to synthetic materials, any nasal implant material can function well in the long-term if properly shaped and well placed. The concept to grasp is that there is no perfect nasal implant material that can guarantee that there will be no future need for additional revisional surgery.

Indianapolis Plastic Surgeon
4.7 out of 5 stars 72 reviews

Rhinoplasty cartilage grafts and synthetic implants are not subject to "wear and tear"

Cartilage grafts are usually permanent when placed inside the nose unless they become shifted or dislodged.  We usually recommend the patient’s own cartilage from the nose or the ears, however implants, such as silicone and Gortex, also do not need to be removed unless then become infected.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Does Rib Cartilage Nose Graft need to be routinely Removed or Revised?

When nose surgeons need to raise the roof of the nose they consider various materials as potential onlay grafts including Man Made implants (Goretex, Silastic, Porex / Medpor etc), other humans (cadaveric  rib) or your OWN body (septum, ear cartilage or rib). Unless the graft is penetrated by your own blood vessels and becomes an integral part of your body, as your own tissues will, eventually they will become infected, coveredby hard scar tissue or be pushed through the skin and become extruded. Although ALL grafts can suffer these complications, the likelihood of tissue grafts from your own body having to be removed is much lower.

Peter A. Aldea, MD
Memphis, TN

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 108 reviews

Replacement of Nasal Grafts

Synthetic grafts such as Silicone, Gortex, and Medpor may have to be removed over time because they move, extrude, or become infected. There is no "wear and tear" on these grafts. I prefer using the patient's own cartilage harvested from the septum, ear, or ribs because these grafts become incorporated into the patient's surrounding tissue and therefore are more likely to be permanent.. Replacement or revision is rarely necessary.  

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Do Rib Cartilage Implants Have to Be Replaced or Revised After a Few Years of Use, Like Silicone and Goretex Implants?

  I have performed Rhinoplasty for over 22 years and IMHO, I disagree.  Silastic dorsal nasal implants could be left indefinitely.  Goretex has a tendency to get infected years later while rib cartilage/bone tends to dissolve unevely over years requiring it's removal.  My preferrd method of dorsal augmnentation is a straight silastic implant while I've found conchal ear cartilage the best material to augment the nasal tip.  Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Rib cartilage and revision for noses

Rib cartilage or septal cartilage are usually teh best tissues we have to onlay the dorsum of the nose.  The main issues with cartilage grafts is that they can warp( bend) this can happen over time as well.  The complications with these grafts are lower than with implants (silicone, and other materials)

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Do Rib Cartilage Grafts Need To Be Replaced?

If the rib graft is properly shaped and placed and has healed in its desired position it will not need to be replaced.  I have revised some noses where rib cartilage has been used and have usually found the cartilage to be in excellent shape years after the original operation. I operated on a lady who had had a rib cartilage used for dorsal augmentation 51 years prior to my operation and the cartilage graft was intact!

Dr. A. Gantous

Andres Gantous, MD
Toronto Facial Plastic Surgeon
4.8 out of 5 stars 25 reviews

Grafts in Rhinoplasty

The goal for any graft I place in a Rhinoplasty patient is for it to be permanent. The only reason to remove an implant is secondary to a complication they do not wear out as you have suggested.

Jay M. Pensler, MD
Chicago Plastic Surgeon
4.6 out of 5 stars 14 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.