When considering rhinoplasty, one of the most important decisions is "which material to use." The internet is filled with abundant information, but there are also many articles that excessively recommend specific materials. In this article, from the perspective of a medical professional, we will explain objectively and honestly the merits and demerits of major materials such as autologous rib cartilage, silicone, and Medpor. Please use this as a reference for realizing your ideal nose.
1. Autologous Rib Cartilage: The Ultimate Material That Becomes Part of Your Body
Autologous cartilage (ACC) is a method that uses cartilage harvested from the patient's own rib bone. The greatest merit is that since it is self tissue, biocompatibility is extremely high, and ultimately blood flow recovers around the tissue and it becomes established as part of "your own nose." Once stable, unlike artificial materials such as silicone, it does not require future replacement, and long-term stability can be expected.
On the other hand, there are several important considerations. First, a small incision on the chest is necessary to harvest the cartilage, and there is a slight risk of scarring remaining (approximately 3%). Additionally, as a phenomenon unique to autologous rib cartilage, there is a reported probability of approximately 5% that the cartilage will slightly bend over time, a phenomenon called "warping (distortion)." Furthermore, since it undergoes strong adhesion as self tissue, should you wish to change the design in the future, removal and re-correction become extremely difficult compared to artificial materials.
Statistically, autologous rib cartilage has a higher complication rate than other materials (approximately 14%), but this is thought to be because this material tends to be chosen for difficult revision surgeries.
2. Silicone Implant (prosthesis): Ease of Revision and Design Freedom
Silicone is the most widely adopted artificial material in rhinoplasty in the Asian region due to its affordability and ease of processing. A major advantage is that it makes it easy to create a clear nasal line and allows the shape to be easily adjusted according to the patient's preferences.
Additionally, what should be particularly noted about silicone is "the ease of revision." According to one meta-analysis, the removal rate of silicone is reported to be approximately 12%. While this may appear to be a high figure at first glance, it is also evidence that "if a problem occurs or you want to change the design, the material can be safely removed and replaced without damaging surrounding tissue." Because it does not undergo adhesion to surrounding tissue like autologous tissue, for those considering future maintenance or design changes, it becomes a major source of reassurance.
However, as a long-term risk, the possibility of implant exposure, infection, or deformation due to calcification cannot be denied. Therefore, recently, techniques to reduce risk by covering silicone with autologous cartilage (such as auricular cartilage) have become common practice.
3. Medpor: Risks and Current State of High-Density Polyethylene
Medpor is a porous synthetic material that has been said to have excellent fixation strength because tissue can easily infiltrate it. As initial surgical results, good aesthetic and functional outcomes may be obtained.
However, in medical practice, its risks are taken seriously. The greatest problem is that due to its porous structure, surrounding tissue becomes deeply infiltrated into the material (adhesion), making removal extremely difficult when complications occur. When infection or exposure happens, surrounding tissue must be separated while causing significant damage, and revision carries the risk of causing severe inflammation and tissue defects. In fact, it has been pointed out that revision following Medpor is far more difficult than revision using autologous rib cartilage in secondary surgery.
Furthermore, in some overseas regions, troubles from unauthorized use in situations where safety has not been fully confirmed have been reported, requiring careful consideration in material selection.
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4. Comparative Summary of Each Material
5. Conclusion: Making the Optimal Choice Through Dialogue With Your Doctor
There is no "absolutely correct answer" when choosing a rhinoplasty material. Autologous rib cartilage provides lifelong peace of mind, but revision is difficult. Silicone offers the convenience of flexible response to future changes. Medpor has strong fixation power on one hand, but the cost of trouble on the other is very high.
Which material is optimal for you depends on your nasal condition, surgical history, and your life plan regarding what kind of nose you want to maintain in the future. What is important is to choose a doctor who explains not only merits but also demerits honestly, and to consult thoroughly in counseling until you are satisfied. Weigh the risks and benefits and find the best choice for you together.
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Author of this article
Hiromitsu NakamuraPhysician
Zetith Beauty Clinic Ginza, Osaka, Fukuoka
With a track record of research presentations at domestic and international conferences, he also participates in technical guidance and education throughout Zetith Beauty Clinic. Specializing in precise rhinoplasty based on anatomical evidence, he pursues natural results tailored to each individual's skeletal structure and tissue.