Do Nasal Implants Last A Lifetime?

Q: Dr. Eppley, I read your article on natural vs. artificial implants in rhinoplasty.  I was wondering why you prefer natural material. I also know diced cartilage wrapped in fascia has been offered fairly recently.  Do you know if this is a fairly new procedure or if this has been offered since 2009?  I am considering tip revision but also want to keep my bridge area in mind if need be.  I have an implant in my nose as mentioned earlier but do not know if these implants last a lifetime. I had mine placed when I was 38.  Is there some kind of average, for example, 20 or 30 years?  Thanks.

A: Significant nasal augmentation in rhinoplasty can be done with either nasal implants, usually made of silicone, or rib cartilage. There are advantages and disadvantages with each type of implant/graft and both can have successful long-term results. Silicone nasal implants never change in shape or structure, can not degrade or break down and never need to be replaced because they fail. The issue with any synthetic nasal implant is that the tissues change around them in some cases (if they are big enough) and this means that the skin over the implant thins. This can lead to potential long-term issues such as implant show, exposure or infection. This never happens with cartilage grafts which is why they are preferred in larger nasal augmentations if one is willing to invest the greater effort up front.(longer surgery, scar, expense)

The use of diced cartilage wrapped in fascia or surgical in rhinoplasty is not new and has been around for several decades. It s biggest advantage over en bloc or solid rib grafts is that there is no potential for warping or edging. They can be used to cover a nasal implant particularly in the tip area. But the use of ear cartilage would actually be better for this purpose.

Dr. Barry Eppley

Indianapolis, Indiana