What is Augmentation Rhinoplasty?
Rhinoplasty may require the addition of material to augment the nose which is sometimes necessary for both aesthetic and functional indications.
Functional reasons for augmentation rhinoplasty include providing structural support for areas deficient of material, such as the upper or lower lateral cartilages or for aesthetic reasons.
Typically, augmentation rhinoplasty is performed to increase the projection of the nasal dorsum or nose on the profile view. The nasal tip may also be augmented. In addition, grafts may be placed to camouflage irregularities of the bony dorsum and of the upper or lower lateral cartilages.
A number of materials are available to the augmentation rhinoplasty surgeon to augment the nose. These include silicon implants, gore-tex and natural cartilage grafts usually from the patients own nasal septal or ear cartilage.
Augmentation Rhinoplasty With Silicone Implant
A Silicone nasal implant are the most commonly used synthetic material for Rhinoplasty. This material has used over several decades and thus has been tried and tested over the years.
The implants, silicone nasal implants, usually comes pre-formed, but your surgeon can trim and sculpt the implant depending on the shape and size of the new nose you have discussed upon.
Silicone nasal implants are usually used as the popular material of choice because it can easily be inserted into the nose, as well as, easy to remove in case any problem arises over the years.
Among the Asian rhinoplasty population, silicone nasal implants are considerably more popular given the fact that Asian noses typically have an insufficient amount of native cartilage support to provide even moderate definition.
For rhinoplasty with silicone implants, a minor incision is required to insert the silicone implant and a closed rhinoplasty approach is usually used. Rhinoplasty with silicone implant is good for more pronounced nasal bridge lifting effects. Augmentation rhinoplasty with silicone implant is generally peformed Under IV Sedation.
The Disadvantages of Rhinoplasty Using Silicone Implants.
For many years in the past, most cosmetic surgeons particularly in the Philippines use solid silicone implants in their rhinoplasty procedures. However, silicone implant is made of synthetic material and it has received considerable criticisms for its high rejection rate and for giving un-natural nose appearance after the surgery.
The following are some of the side effects of silicone implants which are the same reasons why it is not preferred to be used nowadays:
Silicone implant heals by encapsulation where the body’s natural reaction to a foreign body is to form a capsule around it.
Unfortunately, while encapsulation can keep the implant in the general vicinity, it does not prevent the implant from moving around during the healing process of rhinoplasty.
Due to the pressure by the silicone implant on the nasal tip as a foreign material, it causes pressure necrosis and a pig nose look which is the implant’s upward movement.
Scar-like tissue, If the implant is not immediately removed on the bridge of the nose, may make the appearance cosmetically unacceptable.
Silicone implants are recommended to be changed every 20 years.
Augmentation Rhinoplasty With Ear Cartilage Implants.
There are rhinoplasty surgeons who prefer using natural cartilage grafts over silicone implants and is usually the first choice for augmentation rhinoplasty. This lessens the risk of developing infection, since the “material” used comes from the patient.
Cartilage is generally required in cases where either too much cartilage was removed from prior nasal surgery or in cases where the nose needs addition of cartilage to optimize its cosmetic appearance
Augmentation rhinoplasty using ear cartilage requires harvesting cartilage from the donor site and surgically inserted into the nose to achieve the size, shape and contour of the desired new nose.
Augmentation Rhinoplasty With Ear Cartilage Graft is performed normally Under IV Sedation
Using Ear Cartilage For Rhinoplasty Surgery.
Cartilage is generally required in cases where either too much cartilage was removed from prior nasal surgery or in cases where the nose needs addition of cartilage to optimize its cosmetic appearance or nasal function.
For many patients, the lower nose is the area that makes the nose unattractive. This typically occurs in patients with weak, drooping cartilage at the tip of the nose. For these patients, cartilage grafting is the core of improving their appearance because it enables the surgeon to strengthen and reshape the structure of the nasal tip.
Rhinoplasty With Gore-Tex Implants
Augmentation Rhinoplasty with Gore-tex and Tipplasty is another Rhinoplasty procedure that is based on the physical structure of the patients nose and the required expectations of the patient.
Gore-Tex uses a material made out of pliable and porous material, which allows tissue in-growth to develop. This means that the new tissue growth after the surgery will bind with the material and eventually forms part of the nasal structure.
Augmentation Rhinoplasty with Gore-tex and Tipplasty is performed Under Local Anesthesia
What Are The Advantages Of A Gore-Tex Nasal Implant?
Because of its flexibility, it is easier to mold and contour the material into the desired shape.
Gore-Tex gives a more subtle and natural looking nose lift in comparison to the results achieved by Silicone implants
Since Gore-Tex integrates well with the tissues, it does not usually get displaced over time. Gore-Tex is also capable of withstanding extreme temperatures, unlike Silicone.
What Are The Disadvantages Of Using Gore-Tex Implant?
Gore Tex is more expensive than Silicone Implants.
In the case of infection, it is nearly impossible to remove the Gore-Tex implant as it integrates well with the nasal tissue.
There is also possibility of shrinkage in the case of Gore-Tex. As we age, the soft material of Gore-Tex is prone to changes.
A revision rhinoplasty, if required, would inevitably cause damage to the surrounding nasal tissue.
Dorsal Augmentation Rhinoplasty (Bridge Augmentation Rhinoplasty)!
Dorsal augmentation rhinoplasty or bridge augmentation rhinoplasty is a valuable means of improving nasal appearance in patients with a low and/or concave nasal dorsum, which is the border between the root and the tip of the nose which in profile can be variously shaped.
A commonly encountered issue in rhinoplasty surgery (especially in ethnic rhinoplasty with Asian and African American noses) is the low bridge or dorsum. This can lead to the appearance of a wider nose and it also tends to create a more washed-out, less defined appearance to the face. More extreme levels of rebuilding of the dorsum is found in saddle nose deformity cases.
So what is the best way to augment the bridge? The options basically boil down to whether to use a patient’s own tissue (cartilage, bone, fascia) versus a synthetic product (silicone, medpore, or gortex).
Our Board Certified rhinoplasty surgeons prefers using a patient’s own tissue for augmenting the nasal bridge (septal, ear or rib cartilage) as it is incorporated into the nose in the most natural manner.
In certain cases synthetic materials may be considered depending on the situation and patient preferences.