What Are the Pros and Cons of Getting a Nasal Implant Versus Cartilage Grafting?

Over more than 35 years of rhinoplasty I have only used the patient's tissue and never had an infection. Therefore, I see no reason to take the risk of possible infection using a foreign material.

It is always best to have the patient’s own cartilage implanted in the nose rather than a synthetic implant with the exception of Asian rhinoplasty and very large dorsal augmentation requirements.  A synthetic implant such as silastic is an excellent implant and is well tolerated in the body but there is always the extremely rare chance that it can get infected.  Small to moderate augmentations are usually done with the patient’s own cartilage while moderate to significant augmentations of the bridge are performed with silastic synthetic implants.

It appears that North American Surgeons operating on Caucasian and African-American patients prefer cartilage. It is predictable in our hands and has a low complication rate.

We see though many Oriental patients : Vietnamese, Korean patients who have implants placed by Oriental Plastic Surgeons with great results and low complication rates.

I do not know if it is the Oriental  patients nasal skin which is different or the Surgeons familiarity and experience with the implants .

This may answer your question from a different point of view.

Good luck !

It is a little more complicated than just implant vs. cartilage because there is more than one type of implant material. Each one has it own pros and cons and surgeons tend to work with the implant material they have the most experience with. To able to make an informed choice you need to consult with a qualified surgeon face to face, actually see the different materials, have the surgeon go over the different implants and cartilage pros and cons and then you choose which you want. You cannot do that online in this forum.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Nose "implants", that is, artificial material, have the advantage of being readily available in any quantity, and they will stay where they are put and not change in shape over time.  They have a significant disadvantage in having an infection rate of about 3% which necessitates removal.

Cartilage, if available in enough quantity, has a less than 1% infection rate, but will not necessarily retain its size and/or shape.

Implants cannot be used for structural purposes in noses.

The use of prosthetic nasal implants should be used with caution in the nose for fear of infection,extrusion and dislodging even years after the original surgery.   Cartilage grafting does involve a donor site(intranasal cartilage if available,ear cartilage, or rib cartilage), however, the tissue should become revascularized and present less problems with regard to infection or extrusion.   

i always prefer your own tissues when working on a nose. the skin is thin, and vascularized tissue is better in my opinion. advantages of implant, is no donor site or discomfort is necessary where you would take the tissue from. disadvantage is potential of infection short or long term as the implant is not vascularized and part of your body. cartilage or bone, will get blood supply from the surrounding tissues and therefore resists infection better.

The benefit of cartilage grafts is that they are your own natural tissue so risk of infection or rejection is lower.

The benefit of implants is they are readily available and you avoid donor site complications of the cartilage graft. They also do not warp as cartilage does but have a higher risk of extrusion.

Good Luck 

Using a cartilage graft as opposed to artificial material, will have a lower chance of extrusion and infection. Implants are typically used when there is not sufficient cartilage available to reshape the nose. I find this to be virtually never the case.