I've heard of Goretex, Silicone, and cartilidge for augmentation of an asian nose bridge. What are the respective costs of each material and in your opinion the safety/effectiveness in the short and long term of these materials. mostly I would like permanency and a low risk of infection. For a very flat nose bridge that needs a significant augmentation, which material sounds good?
What is the Safest Material for Asian Nose Bridge Augmentation? (Rhinoplasty)
Doctor Answers 30
Rhinoplasty - materials for augmentation
As a fellow Asian woman - I completely understand what you mean by an "asian bridge"!
In general, using material from your own body has the least chance of rejection, extrusion, or infection. Also, it is the cheapest. If you need a lot of augmentaion, you can get more bulk by using rib cartilage which is also sometimes wrapped in fascia (another piece of your own tissue).
Best of luck!
Dr. Cat Huang Begovic
Best material for building up nasal bridge
I prefer using a patient's own tissue for augmenting the nasal bridge (septal, ear or rib cartilage) as it is incorporated into the nose in the most natural manner.
There are risks with warping of cartilage grafts (mainly rib cartilage) but by using advanced cartilage carving techniques I have not found this to be an issue in my own practice.
Silicone, medpore or gortex are alternative implant materials that can be used. They are more commonly used in patients with thicker skin, especially Asian patients. They come in L-shaped and I-shaped. The L-shaped type is meant to augment the nasal tip, but in a way which I don't feel looks particularly natural.
I have seen many patients with silicone implants that were placed years or decades ago who presented to me with delayed reactions to the implants necessitating implant removal.
Safest material for augmenting nasal bridge
Silicone implants are the best implant and tolerated quite well if used conservatively in an Asian patient’s face. The cost of a rhinoplasty is approximately $6000, which includes the operating room, anesthesia, and the surgeon’s fee for performing the procedure. On a rare occasion the implants can get dislodged or crooked and needs to be removed and reimplanted, which is a relatively easy touchup procedure. Gortex has is more likely to become infected, has more tissue ingrowth, is very difficult to remove, and can be problematic if it gets infected. We do not recommend it. Cartilage augmentation from the patient’s own septal cartilage is an excellent alternative, although in the flat low Asian nose there is simply not enough cartilage to sufficiently build up the bridge, so silicone silastic implants tend to be the best alternative. We recommend small and medium sizes so as not to put extra stretch on the skin, which can cause tissue necrosis and breakdown.
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I like a combination fascia, along with your own cartilage, either diced or a whole intact piece.
Silicone implants have been safe and economical way to augment Asian nose
I have had alot of success over the past 28 years augmenting Asian noses using silicone implants. I believe that they are safe and effective, and economical. Usually they give very good results. Other materials including the patient's one bone, cartilage, and other synthetic material have been tried and used successfully. All materials have their potential for complications and you should consult with a board certified plastic surgeon to discuss the pros and cons of each.
The use of your own tissue is the safest for nasal augmentation. Sources of this tissue include bone and cartilage from the nose, or ear cartilage or bone from the iliac crest. Temporary improvements can be achieved with fillers like Hyaluronic acids like Juvederm or Restylane.
Rhinoplasty Material to Build the Bridge
As other rhinoplasty surgeons have stated, cartilage is generally the ideal material to build the bridge. Cartilage is typically obtained from the nasal septum or ear. Occasionally, rib cartilage may be required for rhinoplasty. Goretex and silicone have been used with good results for rhinoplasty too. Rhinoplasty surgery is permanent, but revisions may be required as needed. Foreign materials, such as Goretex and silicone, have a higher chance of infection as compared to your own natural tissue. Only after a comprehensive evaluation can a rhinoplasty surgeon help determine appropriate options for you. Best of luck.
Cartilage is the safest,
I have used septal or ear cartilage for 35 years and have never had any infection or rejection. Therefore, I feel it is the best.
Safest Material in Rhinoplasty? Cartilage
There is really no question that your own cartilage (septal, auricular, or rib) is by far the safest and most preferable material for use in augmenting the nasal structure in Rhinoplasty. Non-native materials are generally utilized only when there is a lack of autogenous cartilage available. Any foreign material carries with it the life-long possibility of extrusion when used in Rhinoplasty.
For significant augmentation, I prefer custom carved silastic implants. I have been using this implant for the past 10 years and had one incident out of hundreds where the implant needed to be removed because of infection.
Silicone implants get a bad rap because usually surgeons use "out of the box implants". These implants are not custom fit and can extrude much easier. The key is to use a custom carved implant placed in a precise implant pocket over the bridge of the nose. The implant pocket is crucial and must be a perfect fit for the implant. It is then secured with a suture. You can check my website for more info on the custom carved silastic implants.
For slight augmentation, septal or ear cartilage works well. I have seen some pretty ugly, warped rib cartilage grafts that are very difficult to fix.