There are a variety of material and grafts to use for nasal dorsal augmentation from different cartilage harvest sites, cadaveric cartilage and synthetic implants, each with their own advantages and disadvantages. In ethnic rhinoplasty often the amount of dorsal augmentation is significant so the choices narrow down to the patient's own rib cartilage, processed cadaver cartilage or an implant. If you are young and the grafting need is great your own rib cartilage may serve you the best long-term even though it is a bigger investment up front.
Dorsal graft material
If one needs a lot of dorsal projection, then rib graft may be necessary. There are other options like cadaver cartilage, or like you said silastic implants.
Best Material to Augment the Nasal Dorsum/Radix
There are many options but I have used fascia for the radix and diced cartilage in a tube of fascia to augment bridge and dorsum for many years. I prefer to use the use of the patient's own tissue rather than synthetic silicone implants that are prone to infection, movement, and extrusion.
Nasal cartilage for dorsal augmentation
Nasal cartilage is always the gold standard for augmentation of the nasal bridge. Rhinoplasty is a very difficult endeavor, such as your surgeon very wisely based on extensive experience
Low radix in ethnic nose
It is a tough issue. Ideal implant should be your own cartilage but trying to get a perfect shape using your own cartilage is very challenging. A Flowers implant made from Silicon has worked well in radix area for ethnic noses. I would start with that and if there is any failure down the road then opt for the cartilage. RegardsDr. Janjua
ferrarithunder3588, go with the first doctor; no doubt it is very easy to slip in a silastic implant but over the long haul there are too many risks for me to use this approach. See a facial expert with years of experience and good photos. Good luck!
Hello and thank you for your question. I 100% agree with using your own cartilage from your septum or ear. Silicone implants in the nose have a high rate of infection, exposure, and malposition over time. Even 5 or 10 years after surgery they can have complications.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon