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Artificial Implants - Goretex

Dr. Harris will answer all your questions about facial plastic surgery for African-Americans and people with skin of color, including rhinoplasty (nose job), facelift, eyelid surgery (blepharoplasty), lasers, dermal fillers and all other types of facial plastic surgery.

Artificial Implants - Goretex

Postby covgirl33 » Thu Oct 22, 2009 11:48 am

Hi Dr Harris,

Black female here considering rhinoplasty. I want to build my bridge up, just wondering what your opinion of grafts such as goretex and silcone was? Ive read that lots of surgeons are against them totally whereas some still use them to build up a low bridge. However they have a potential risk of extrusion or infection, Ive read some of these instances online and it doesnt make for good reading. I know that risk might be small but its just a risk I wouldnt want to take, especially as Id be flying in to see you. Have you seen instances of goretex extrusions/infections? I read a post from Dr Naderi here who said he uses it in select cases but thin sheets wrapped in natural cartilage, is this similar to your method?

http://www.harrisface.com/images/proced ... ore425.jpg
http://www.harrisface.com/images/proced ... _after.jpg

I adore this result, I cant put it into words how nice that new nose looks. Its perfect. Absolutely perfect :D :D :D

Was an implant used in this case? If so, could I gain the same kind of result not using an implant? Also, if a patient is against an implant like myself is there ways to use other bits of cartilage that will do the job? I know some surgeons can build up a low bridge with rib cartilage. I suppose my question is why would a surgeon use an implant if they didnt have to or is there some kind of additional benefit and a reason they have to? (this is for a primary)

Thanks Dr Harris
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Joined: Sun Sep 21, 2008 3:21 pm

Re: Artificial Implants - Goretex

Postby drharris » Tue Nov 17, 2009 8:38 pm

Hi covgirl33,

My first material of choice for building up the bridge and is septal cartilage. Patients of African descent frequently do not have enough septal cartilage to reshape both the tip and elevate the bridge. In those instances, I prefer septal cartilage for the tip and commonly use a synthetic material such as Goretex or ePTFE to elevate the bridge. I have found this material to be quite safe in my hands. I have not had any cases of extrusion or infection. With my natural appearing results, I do not tend to elevate the bridge excessively so there is no tension on the overlying skin . . .significantly reducing any associated extrusion risks. Patients with skin of color, particularly those of African descent also tend to have thicker skin further reducing the risks of infection or extrusion. I do not use autogenous rib cartilage for primary rhinoplasty . . .it think it's a bit excessive for an initial operation and feel it's better reserved for revision cases if necessary.

Thanks for the compliment regarding my rhinoplasty patient's result. She actually did not have an implant placed. This shows that you can achieve very elegant and natural appearing results without elevation of the bridge. I concentrated primarily on improving her tip definition and projection. Osteotomies were performed to narrow the bridge.

I hope this helps . . .and look forward to seeing you in consultation.

All the Best,

Dr. Harris
Monte O. Harris, MD
5530 Wisconsin Avenue, Suite 612
Chevy Chase, MD 20815
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Joined: Wed Jul 30, 2008 12:02 pm

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