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Silicone (also known as Silastic) implants are occasionally used in primary rhinoplasty and revision rhinoplasty. The most common use of the silicone implant is for augmentation of the bridge of the nose in Asian rhinoplasty and African-American rhinoplasty. Silicone implants can be carved and shaped prior to placement inside the nose.
- No donor incision (i.e. rib or ear) is needed
- Silicone offers some structural support (more than Gore-Tex) although not as much as cartilage
- Silicone is not very structurally strong and cannot be used to lengthen a significantly short nose, provide tip support, or correct significant deviations in cartilage
- Silicone is prone to infection and if infected it typically needs to be removed
- Silicone implants can extrude years after the original surgery
Rib cartilage grafts are an alternative to Silicone. Autologous rib cartilage grafts (obtained from the patient) can accomplish everything that Silicone can with the added benefit of resisting infection, but they do require an incision on the chest.
Cadaveric rib cartilage grafts (obtained from a cadaver) do not resist infection like autologous rib cartilage, and if an infection occurs the cadaver rib cartilage will often resorb (disappear). Cadaver rib cartilage also comes with a potential of human-to-human disease transmission
Other synthetic implants such as Medpor and Goretex are alternatives to Silicone. Goretex is less likely to move and shift than Silicone. Medpor is more rigid than Silicone and is also less likely to shift and move than Silicone.
Synthetic implants typically do not require any special care after surgery other than the need for a course of antibiotics and awareness of the possibility of infection. If a Silicone implant is infected the signs can be redness, pain, warmth, swelling, drainage from the nose, foul smell, drainage through the skin, and in extreme situations fever and chills. If this occurs the implant typically needs to be removed to successfully resolve the infection.