I have goretex implant to my nose in about 1 and half years..

Question

When I'm tired at night I noticed the skin of my nose it seem like its get thin and you can the mark of the goretex inside my nose.. Beside that has lump at the top of my nose. Is this normal?

Larry C. Leverett, MD, FACS · Answer

If you can wee the cortex at the end of the nasal tip, there Is a high likelihood that you have a pending extrusion of the gortex. See your local board certified plastic surgeon who will not only arrange to have it removed, but also arrange to have a reconstruction using your own tissue.

Bhupesh Vasisht, MD · Answer

You should have your surgeon look at this issue to make sure its not extrusion of the implant.  This is not normal and hard for us to advise you on this forum.  It needs an examination.  Hope this helps.

Samir Undavia, MD · Answer

Sometimes synthetic nasal implants can extrude, especially if there is thin skin overlying it. I would have it examined so that if something needs to be done, it can be done early to help prevent getting an infection or  skin breakdown. Good luck!

Fred J. Bressler, MD, FACS · Answer

I would be concerned that you are experiencing a localized skin reaction/ sensitivity to the Goretex Implant. The risks are well known and lumps and abnormal swelling especially at the top of the nose where the skin and soft tissue envelope are thinnest, is the first place this presents itself. I have seen this problem occur in patients even more than 5 years from Goretex implant insertion. It is more common with revision rhinoplasty patients, but is often seen in primary rhinoplasties too. If it persists or gets worse, it may be best to have the Goretex implant removed. Second stage replacement with cartilage grafts could be considered. Some patients will tolerate re-implantation with Goretex as long as the implant is "wrapped" in fascia or Alloderm which prevents direct contact with the skin. Personally, I have abandoned the use of Goretex Nasal Implants, in favor of cartilage grafts from autologous ribs or allografts ribs from the tissue bank. Consult with your physician and discuss your options.

Steven Wallach, MD · Answer

Nasal implants are always at a risk of extruding. It sounds like you have a very thin skin envelope.  You may need further soft tissue coverage to better camouflage the implant.

Remus Repta, MD · Answer

Thank you for the question.  The evening time seems to be a time when we may have less water content in our skin and soft tissue of our face for sever reasons.  Because of this, your overall skin thickness will be slightly less which results in the nose implant being seen.  Camouflage of this with filler or fat may be helpful.  Permanent repair of this would require some type of rhinoplasty to deal with the implant itself.All the best,Dr Remus Repta

Bryan Friedman, DO · Answer

I'm sure this can be unsettling to you.   There is a small risk of extrusion, where the implanted material works its way through the skin.  A short visit to your surgeon along with an examination can set your mind at ease as well as makes sure no intervention is required

Richard W. Fleming, MD (retired) · Answer

Seeing an implant, in your case Gore-Tex, is not normal after rhinoplasty surgery. Consult with your surgeon or an experienced revision rhinoplasty surgeon. This can be a sign of impending extrusion.

I have goretex implant to my nose in about 1 and half years..

Answers (8)

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