Nose bridge augmentation Implant (prosthesis): What's the difference between silicone and Gore-Tex?

The Implant (prosthesis) materials used in nose bridge augmentation include silicone, Gore-Tex (ePTFE), and Medpor (high-density polyethylene), and they behave differently within the body[1]. Silicone is a non-porous material, so a membrane forms around it making it easier to remove, while Gore-Tex is suited for raising the nasal bridge but is not recommended for areas requiring support[1][2]. Which one suits you depends on where you want to add volume, skin thickness, and whether your own cartilage can be used[2][3].

What's the difference between the artificial materials?

The biggest difference is whether the material has pores and how the body reacts to it. Silicone has no pores and a fibrous membrane (capsule) forms around it, so removal is relatively easy[1]. However, the rates of exposure and infection vary by report, and reviews state that careful patient selection is necessary[1].

Medpor is a porous material that can be shaped by carving and is often used for placement on the cheeks and chin[1]. Gore-Tex is particularly useful for raising the nasal bridge, but cannot be used in areas requiring support, and its use in other nasal sites is not recommended[2].

How much do complication rates differ?

Direct comparisons between artificial materials are limited. A 2008 meta-analysis collected 20 reports total—8 on silicone, 7 on Gore-Tex, and 5 on Medpor—and summarized rates of removal, infection, exposure, and revision surgery[2]. A 2022 meta-analysis citing this analysis summarizes that artificial materials have acceptable complication rates and become an option when patient's own tissue is difficult to use[3].

A 2025 systematic review of facial artificial materials overall found that among 117 studies and 4,273 people (average follow-up 34 months), overall complications were 4.4%, nerve injury 2.1%, infection 1.0%, hematoma 1.4%, displacement 0.59%, and bone resorption 0.68%[4]. However, these figures primarily cover artificial materials in the orbit, chin, and cheeks, not nose-specific numbers[4]. The same review reports that polyethylene-based materials had the highest rate of complication-free recovery[4].

Why is silicone still widely used?

Despite known drawbacks, silicone has been used for over 40 years and remains the most widely used artificial material, especially in Asia[1]. Although criticized for exposure, infection, displacement, and visibility, meta-analyses state that when experienced physicians handle it without damaging blood flow to nasal tissue, it remains an option in selected patients for both primary and revision surgery[2].

As a measure to reduce infection, many authors recommend placing the incision as far as possible from the pocket where the artificial material is inserted[1]. Where to make the incision and insert it is as important a consideration as the material itself[1].

What type of nose is unsuitable for artificial materials?

Thin-skinned noses and noses requiring support are the dividing line. With any artificial material, if soft tissue beneath the skin is insufficient, the material directly contacts the dermis and exposure becomes more likely[2]. Gore-Tex cannot be used in areas requiring support[2].

The advantages of artificial materials are lower cost, no scar from harvesting your own tissue, and ease of shaping[3]. Conversely, for people who can harvest sufficient cartilage from their own body, artificial materials are positioned as an "option when autologous tissue is difficult to use"[3].

Organizing selection into three axes

Thinking along three axes makes it easier to organize. Is the area to be augmented only the nasal bridge, or does the nasal tip also need support?[2]. Is the thickness of skin and soft tissue sufficient?[2]. Can you harvest your own cartilage, or can you accept the scar from harvesting?[3].

Material selection is determined by surgical goals, anatomy, and patient preferences, requiring individual planning, as the review concludes[4]. The review also clearly states that research on long-term outcomes and safety is still insufficient[4].

What to confirm at consultation

What you want to confirm is the thickness of your nasal skin, the height you want to add, and whether support is needed[2]. If using artificial materials, ask your doctor which material, in which layer, through which incision will be placed, and how infection or exposure will be managed if it occurs[1][2].

For noses with capsules or scars from previous surgery, material selection changes[1]. Have your doctor examine the condition inside and outside your nose at consultation, and work together to determine whether artificial materials or autologous tissue is better suited to your nose.