What material / graft is best for dorsal augmentation in ethnic case where radix area is very low?

I've consulted with doctors to augment dorsum and am torn with the inconclusive answers regarding which material / graft is best for this both aesthetically AND long term. Found 2 good doctors, but one uses septal + ear for the dorsum, while another suggests a custom silastic implant is best to achieve significant augmentation. A lot of the answers on this site to the question are from 2010 and would like more recent answers that factor in any developments / new technology in the area.

Doctor Answers 7

Dorsal Augmentation

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.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

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.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

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

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 reviews

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

Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 98 reviews

Nose augmentation

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!

M. Sean Freeman, MD
Charlotte Facial Plastic Surgeon
4.7 out of 5 stars 46 reviews

Dorsal augmentation

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

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 80 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.