In medicine, the term graft is used when one part of your body is moved to another part of your body. Rhinoplasty surgeons frequently use grafts to build up a patient’s nasal framework and give the nose its shape. There are several types of natural and synthetic grafts available to rhinoplasty patients, each with its own advantages and disadvantages.
Natural Grafts
Natural grafts can be created through harvesting cartilage surgically from the ear, rib, or septum of the patient. Usually the ear is preferred because it’s minimally invasive and has enough cartilage to contribute without drastically altering its shape. Sometimes the septum can be used to create a graft for the nasal tip if the patient has a larger septum or is also having the nasal bridge lowered.
The advantages of this approach are that since the patient’s own tissue is being used in the graft, the risk of rejection or complications is significantly reduced. Cartilage from the patient is also readily available and can be harvested without making any major changes to the cartilage source.
The disadvantages of this approach include that cartilage is difficult to manipulate, which can be problematic if the surgeon needs to form the graft into a specific shape. It’s harder to move once it’s in place, so if the patient should require revision rhinoplasty down the road, the graft could create a difficulty during the procedure. Harvesting the graft from the patient also means that there will be an extra area that will need to recover once the surgery is complete.
Diced cartilage fascia (DCF)also involves harvesting cartilage from the patient, but instead of taking the piece as it is, the surgeon cuts the cartilage into small pieces and then wraps it in a piece of muscle fascia to form the graft.
Itsadvantages are the same as any other natural graft since DCF also uses material from the patient. It has the added bonus of being easy to manipulate. The surgeon will be able to shape the graft to specifically match the patient, offering a better-looking result.
The disadvantages, in addition to the extra recovery sites, are that DCF grafts also have a greater likelihood of being absorbed by the body, which can cause the graft to lose its shape and definition over time. The patient is also more likely to have greater swelling around the graft during recovery.
Synthetic Implants
Silicone is a material that is used in many different types of cosmetic surgery, including rhinoplasty. It’s usually used to change the shape of the nasal tip, but it can be used for the nasal bridge, too. Its advantages are that it is easy to put in, easy to take out, and is very flexible. The disadvantages are that it has an increased risk of rejection or infection and that it is more likely to migrate within the body. There is also a greater risk of the silicone changing shape and even poking out of the skin.
Gore-Tex is one of the newer options in synthetic implants and is also known as expanded polytetrafluoroethylene (PTFE). It’s also used in nasal tips and bridges. The advantage of this material is that it’s basically Teflon, so it’s very tough and durable. It has a lower risk of infection and rejection than silicone. It’s not as easy to manipulate, but it is easy to customize prior to insertion. Unlike silicone, Gore-Tex integrates with the patient’s own body tissues, so it doesn’t move around. Gore-Tex also has a better track record than silicone.
The disadvantages are that as Gore-Tex integrates into the body’s natural tissues, there is a possibility of bacterial growth. It’s also not as easy to remove and could poke out of the skin over time.
Choosing the Best Type Graft or Implant for You
When it comes to choosing between synthetic and natural implants, each patient is different. The surgeon will make a determination based on the patient’s nasal structure, health history, and the patient’s desired results.
Some patients have weaker cartilage that won’t be able to handle the weight of a synthetic implant. Other patients have some shaping needs that alternative implants can handle better. Some people just tolerate synthetic implants better than natural grafts. And sometimes, it comes down to the doctor’s preference. Most surgeons feel that natural implants are safer for the patient, but it will really depend on the patient’s needs as well as the doctor’s experience with the different types of implants.
Further Reading
For more information about natural grafts, synthetic implants and rhinoplasty, read these articles that Dr. Bustillo has published on the subject:
A New Profile, Secondary Rhinoplasty
Anatomy and Analysis
Managing Complications Relating to the Augmented Dorsum
Contact Dr. Bustillo and Schedule Your Rhinoplasty Consultation
Learn more about your implant options with rhinoplasty surgery. Schedule a consultation with Dr. Andres Bustillo, M.D., F.A.C.S.. He’s available to discuss the pros and cons of the surgery with parents and teens and to help a teenager decide if it’s the right option for him or her. He is one of a select few double board certified facial plastic surgeons. He is board certified by both the American Board of Facial Plastic & Reconstructive Surgery and the American Board of Otolaryngology — Head & Neck Surgery.
Because he is a facial specialist, he does not perform surgery on any area of the body other than the face. This specialization and experience has allowed him to get results for patients ranging in facial shapes, features, and skin types. By continuing to build his experience and keep up on the latest advancements Dr. Bustillo has built his reputation as someone who produces natural, long-lasting results.
Over 50 percent of his practice is dedicated to rhinoplasty and revision rhinoplasty. The rest is devoted to other types of facial rejuvenation surgery. He performs over 300 nasal surgeries a year. Twenty-five percent of his patients come from outside the United States. Twenty percent of his patients are other doctors and their families.
He and his team can be contacted by phone at 305-663-3380 or by email through the contact form. The office of Dr. Bustillo is here to answer your questions, and help you to plan your initial consultation. You can also directly contact our patient care coordinator, Jessica, by email. Dr. Bustillo is committed to total patient care and support through his practice based just south of Miami, in beautiful and historic Coral Gables, Florida.
