long-term nasal reconstruction with rib graft can be extremely successful. The main area of problem can be when warping occurs after a large graft is used to build the bridge of the nose. There are several articles that have shown that if the rib is carved in a certain manner, this problem is minimized. Furthermore, I like using diced cartilage wrapped with temporalis fascia as a way of augmenting the dorsum to avoid warping.
Cartilage grafts are pieces of the patient's natural cartilage that are removed from the nose or ear and maybe the rib as you state which are placed in the patient's nose. Once the grafts are fully healed and assimilated, the results are excellent. However, in many cases of nose sculpting surgery the cartilage grafts have the tendency to move, absorb or extrude per Dr. Chugay. According to Dr. Chugay, the use of Gore-Tex produces a natural appearance of the nose with smooth contours, which is not easily achievable with the cartilage grafts regardless of the surgeon's skills. Gore-Tex is a new effective implant material that has undergone extensive testing and has been approved by the FDA per Dr. Chugay. Never the less, there are patients that have had nasal sculpting surgery using the rib cartilage and these patients have no complaints or long term side effects. I hope that this info help to get you to the answer you are seeking Mr. Yosef Shem Tov.
Dear Dr Makor,
The use of gortex as implant in the nose is not new .I used this meterial 20 years ago and i had bed results.It is very easy to use it , but i had 3 cases of infection (out of 10) after a period of 2-32 monthes ,and i have to remove the graft ! I do not recomend the use of synthetic materials in the nose.
Yosef Shem tov M.D.
Hi the Mr. Yosef! Thanks for the info, but please be aware that I'm not a doctor. I am a MSN student and actively working at a surgical center, so please feel free to address me as nurse Makor. I know that Gortex is not that new, but I thought that I put it out there in case you have not gotten the chance to work w/ it. We know that the nose is a dirty area, risk of infection will be much higher if you are not meticulous about prevention of infection especially when using synthetic material. Like I said before, there are patients that have had nasal sculpting surgery using the rib cartilage and these patients have no complaints or long term side effects that we are aware of. Thanks again.
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