Pros and Cons of Gore-tex and Sillicone in Rhinoplasty?

Silicone and Gore-Tex can both pop-out after a rhinoplasty. Did you consider using your own cartilage or bone? These materials are from you own body and the chance that you'll have problems is less. The cartilage can be taken from the middle part of your nose or septum, your ears, and even part of your rib. All of these areas heal well, so talk to your plastic surgeon about these options. Good luck!

Gore-tex is gaining in popularity as a rhinoplasty augmentation material due to its superior integration with surrounding tissues, but long-term data on late extrusion (popping out) is not available. I have seen silicone result in extrusion even many years later. Autologous cartilage does not have those concerns, and some can be obtained from your septum and ear. Cadaver cartilage also has potential problems with resorption but is becoming more available.

Both Gore-Tex and silicone have been used successfully for many years in rhinoplasty.  The positive is that they don't require a donor site, there is usually reduced operative time (because there is no need to harvest), and they don't warp.  The negatives are that they can become infected and/or extrude.  this can happen with either Gore-Tex or silicone and can happen even years later.  Gore-Tex integrates into the tissue which makes it feel a little more like your own tissue, but it also makes it much more difficult to remove if there is a problem.  I prefer to use your own cartilage when possible as there is far less of a risk of infection or extrusion.  Cartilage can be taken from the septum, ear, or rib depending on the amount and strength needed.  See a rhinoplasty specialist who can discuss your goals and from there lay out your options.  All the best!

A frequent goal during rhinoplasty for Asian patients is increasing the height of the dorsum (dorsal augmentation). This gives better definition of the bridge from the frontal view and a fuller, higher appearing bridge from the lateral view. Implants made from various materials including silicone and Gore-Tex are used frequently for dorsal augmentation as they are generally convenient and quick to use during surgery. However, implants in the nose are associated with complications including infection and extrusion (pushing out through the skin) both necessitating removal. Additionally, these implants can twist and warp over time which is a frequent reason why patients prevent for revision rhinoplasty. There are ways to perform dorsal augmentation with your own cartilage from inside your nose (septal), the cup of your ear (conchal) or a small piece of rib cartilage. These pieces of cartilage can be shaped and placed along the dorsum instead of an implant. Although this is technically more demanding and can take slightly longer during surgery to perform than an implant, the results appear to be better longterm as the risk of infection and extrusion are significantly less than with implants. Rhinoplasty surgeons that are experienced with using your own cartilage for dorsal augmentation can perform this procedure efficiently with consistent results. Additionally, there is a technique that combines both your own cartilage and fascia (temporal fascia is a piece of tissue just above the ear under the scalp skin) called diced cartilage-fascia that can be used for dorsal augmentation. Using this technique, it is possible to achieve significant dorsal augmentation but the risk of twisting, warping, or irregularities of the dorsum longterm appears to very low. Patients considering rhinoplasty for dorsal augmentation should give strong consideration to finding a surgeon that is experienced using autologous cartilage for dorsal augmentation.

In general, it is highly unadvisable to use non-autologous material like Gore-Tex or silicone implants in rhinoplasty as the long term effects for infection and exposure are not insignificant. However, in some ethnic populations such as in Asia it is very popular to use a silicone implant. When it is placed deep in the subcutaneous tissue away from the tip, it can last a long time. However, I do not do this procedure. I would prefer to do a nasal dorsal augmentation with the patient’s own ear or rib cartilage or use an injection of hyaluronic acid filler which is biodegradable over a couple of years.

 No reason to use foreign material when you can use your own tissue. Both of these products can cause serious problems, so why take the chance.

I would generally advise that you use your own ear, rib, or septal cartilage.
Any foreign material suchs as gortex or silicone has the possibility of extruding the implants through the skin.

Synthetic implants used for rhinoplasty always add some risk to the procedure. Over time the chance of infection or wearing through the skin is high. A better long term bet is to use a patient's own cartilage to augment the bridge or shape the tip. The infection and extrusion rate is then close to zero.
I have removed many nasal implants of all types. There always seems to be a new and popular implant coming up, but a few years later the story is the same for all of them. Nothing works better, or is safer, than your own cartilage.

I have seen Silicone extrusion more frequently than goretex. The shrinkage of goretex is not a big issue. Its unlikely that it will shrink by 40%. It will give you the height you need and for small base you might need wedge excisions of the alar areas.
Regards

Today, Gore-Tex does not supply grafting material for the nose. We have used Surgiform (also ePTFE), with good success, but it is stiffer to work with. Our ePTFE of choice, for nasal dorsal augmentation, now comes from Implantech. We use ePTFE to augment a flat nasal bridge, and it works well with a complication rate of less than 5% - we have not observed shrinkage of graft material in our patients.

Silicone elastomers (rubberized silicone implants) have a higher likelihood of eventual extrusion.

We do not use any foreign body implants in the nasal tip - just cartilage grafts.

You should discuss your options with a board-certified, experienced Rhinoplasty surgeon with many favorable photos before proceeding.



I hope this helps, and best regards.