Do avoid any alloplastic materials (silicone, medpore, etc) because of infections, extrusions and unnatural results.
Bone is neither recommended, looks artificial and resorption rates are high. Other autollogous materials show similar behaviour.
The right materials to be used as graft are cartilage from the patient's concha auricularis, septum or even rib cartilage. Also temporalis fascial may be used with success.
Tip elevation, projection and definition in a thick skinned nose
Thank you for asking about your rhinoplasty.
I am sorry things didn't turn out as you hoped with your first rhinoplasty.
- In general, cartilage is the best graft material for the nose.
- I have on rare occasions used a silicone graft on a very thick male nose - when the man had no ear or nose cartilage to use and would not accept a rib or human-derived graft.
- Exactly what is needed should be planned in-person with your surgeon and realistic expectations discussed.
Always consult a Board Certified Plastic Surgeon.
Hope you find this information helpful. Best wishes.
Revision rhinoplasty candidate
Without pictures, it's impossible to give any opinion on what may or may not be required. Some patients require cartilage grafting techniques, and others do not with revision rhinoplasty. There are many variables that go into the decision-making process such as current amount of cartilage in the tip, thickness of skin, thickness of the cartilage and the multiple tip support mechanisms. Some patients do not require any cartilage grafting to give increased rotation and projection, while some do require grafts. Any time cartilage grafts are added to the nose, it will make the nose harder and stiffer, since you're adding bulk to the tip of the nose. We do not recommend synthetic implants to the nasal tip, due to the potential of infection. Instead of trying to pick which type of cartilage grafts you may or may not require for your nose, it's better to pick your surgeon, since revision rhinoplasty is the hardest operation to perform in the field of cosmetic surgery. For many examples of increasing tip projection and rotation, please see the link and video below.
Cartilage grafting for revision rhinoplasty.
Cartilage grafting for revision rhinoplasty is what I have used for 35 years without infection or absorption issues. I NEVER use silicone because of infection issues.