Revision Rhinoplasty

Q: Dr. Eppley, I am interested in a revision rhinoplasty. I have a silicone nasal implant and a PTFE forehead implant. While I like the improvement from my forehead implant, it has the unintended consequence of making my nose look too sunken in.

As such, I’m looking at a revision rhinoplasty to give me a higher bridge. I’m also looking for some extra glabella augmentation. After doing some research, I have narrowed it down to either a rib graft or GoreTex. However, this is where my dilemma arises, and I have a few of questions:

– Are you comfortable with using either of these materials for a revision?

– Between a rib graft and GoreTex, which implant material do you think will provide the best aesthetic outcome?

I have read a few people comment that GoreTex can provide more customizable results – do you think this is true?

– Lastly, would there be any issue if either nasal implant material overlapped with the current forehead implant?

Thank you for your time!

A: While both a rib graft and Gore-tex material can be used to augment the radix/glabellar region for your revision rhinoplasty, it would make the most sense to use an alloplastic material since a portion of it will be resting up against the forehead implant material and the lower portion on top of the silicone implant. It would also offer intraoperative adjustability, permanency and the best chance for a smooth transition of the lower forehead into the nose.

Dr. Barry Eppley

Indianapolis, Indiana