Silicone Rhinoplasty
Silicone implants have been used as the implant of choice for rhinoplasty for decades. For a period of time, silicone implants (L-shaped) or implants that were too big were associated with increase risk of extrusions. However, the newer silicone implants are softer and use of the I-shaped implants have allowed a lower complication risk. This is the preferred nasal implant by plastic surgeons as it is easy to put in and also easy to remove, should that need arise. As silicone has been around for a long time, more of the established surgeons are more comfortable with it and it is easier to carve to the desired shape of the patient. Silicone is also relatively cheaper compared to Gore-Tex.
Gore-Tex Rhinoplasty
Gore-Tex which is expanded poly-tetrafluoroethylene (e-PTFE), is a more recent technology which is rapidly gaining popularity with patients. This is also a synthetic man-made material. Gore-Tex usually comes in sheets or blocks and requires carving to shape the implant. It has pores that allow tissue ingrowth which helps the implant to integrate better with the tissues, allowing a more natural look, hence the popularity with patients. However, removal of a Gore-Tex implant is also much more difficult compared to silicone.
Whilst Gore-Tex was reported to have a lower implant removal rate than silicone implants, its overall complication rates seems to be similar to silicone implants. It can be considered an alternative material for augmentation of the nose. Research studies have shown that whilst alloplastic implants have advantages such as it ready availability and no donor-site required, they are associated with a higher infection and extrusion rate compared to using your own native tissues.
And what about total autologous rhinoplasty ? Alloplastic rhinoplasty vs. Total autologous Rhinoplasty.
Alloplastic or synthetic materials such as silicone and Gore-tex are ideal implants because they are unlimited in supply and do not require an extra donor site. However, as they are not of natural tissue, there is always a risk of infection and extrusion requiring removal. This is in contrast to using your own cartilage (either from behind the ear or the rib) to create a rhinoplasty using your own tissue (total autologous rhinoplasty). Once your own tissue has healed it will not have risk of extrusion and even in instances of infection, as the tissue is from your body, there will be blood vessel ingrowth and antibiotics can be used to treat the infections.
Finally, it would be good to have an in-depth in-person discussion with your surgeon. Be it a silicone or Gore-tex or total autologous rhinoplasty, the choice of material is only as good as the comfort and skill of your surgeon in using the respective materials to create the desired outcome that you have.
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