Types of Implants for Rhinoplasty: Artificial Implants, Autologous Tissue, and Allograft Tissue... Let’s Start with the Basics

One of the first things to consider when undergoing rhinoplasty is deciding which material to use. Implants used in the nose are generally materials with minimal tissue reaction and are considered safe, but each material has its own advantages and disadvantages, and the choice depends on the patient’s condition.

Even though many new materials have been developed and introduced for rhinoplasty, they are broadly divided into artificial implants, autologous tissue, and allogeneic tissue. It is not wise to place unconditional trust in autologous tissue simply because it uses your own tissue, and it is also not true that implants are unsafe. Therefore, it is wise to review the basics and decide in consultation with a specialist.

What is especially important is which surgical method is applied to which type of nose and what kind of material is used. Today, I would like to briefly introduce the implant materials used in different situations for rhinoplasty.

Artificial Implants for Rhinoplasty

Silicone

This is the most commonly used implant in nasal surgery. It has been approved by the U.S. FDA and is a product that is harmless to the human body. It does not change or get absorbed in the body, and compared with Gore-Tex, it has the advantage of allowing more precise shaping. In some cases, it may show through when the skin is thin, so it is mainly used when the skin is thick and the nose is low.

Gore-Tex

This is a fibrous material that is very soft, and after insertion it adheres to the surrounding tissue, so it does not move after surgery. It has long been used in surgery to make artificial blood vessels, and these days it is widely used as a nasal surgery material that can replace silicone. Its softer feel than silicone comes from the microporous structure of Gore-Tex, but it also has the disadvantage of possibly settling slightly over time after grafting. It is suitable for cases with thin skin or for surgery focused on the bridge of the nose rather than creating a sharp nasal tip.

Medpor

Medpor is an implant often called “artificial bone” and is mainly used in augmentation of the cheek area, temple surgery, and jaw surgery. Due to its material properties, it may feel harder than other materials.

Autologous Tissue Implants for Rhinoplasty

Ear Cartilage

This is the most commonly used autologous tissue material in nasal surgery and is mainly used for nasal tip surgery. It also plays a role in protecting the skin from the implant placed in the nose.

Septal Cartilage

This cartilage forms the hard, thin wall located between the two nostrils, and it is mainly used to raise the nasal tip or for tip extension surgery in short noses.

Rib Cartilage

The anterior cartilage of the 6th to 8th ribs is used. It is one of the most important materials in rhinoplasty using only autologous tissue, and it is mainly used in short-nose surgery when septal cartilage is insufficient.

Dermal Fat

Dermal fat is a tissue that can be used in patients who avoid implants, in cases where the subcutaneous tissue of the nose is too insufficient after multiple surgeries, or when there was severe inflammation in the past. It can be considered one of the safest tissues for raising the nasal bridge, but because about 30–40% is absorbed within the first year after grafting, it must be grafted relatively large during surgery in anticipation of volume loss over the following months. As a result, the nose may look larger than expected and awkward for a few months after surgery. Because it is far from the ideal of cosmetic surgery, which is to become natural quickly and make the surgical area less noticeable, it is not commonly used despite the quality of the material.

Allogeneic Tissue for Rhinoplasty

Allogeneic tissue refers to tissue from another person that is not your own, but is otherwise the same as your own tissue except for immunological differences.

The most representative example is AlloDerm. Because it is best to perform surgery with a material comparable to autologous tissue, autologous cartilage and AlloDerm are used most often. AlloDerm is a material made by specially processing human dermis, and unlike artificial implants, it is soft without foreign-body reaction and is effective in creating a smooth nasal bridge or tip.

There are many implant options used in rhinoplasty besides the commonly known silicone, and each has its own advantages and disadvantages, with different surgical methods and areas of use. Therefore, rather than thinking of one material as especially superior, the material used will vary depending on the patient’s condition, the surgical area, and the method, so sufficient consultation with a specialist before surgery is the most important thing.

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