kain Posted January 26, 2011 Share Posted January 26, 2011 goretex has been use in rhinoplasty for over 20 years, and has been used to repair heart valves or blood vessels for even longer sorry if i came off as a bit weird or something, but i really try to keep ppl informed on this forum if i see them posting something that looks inaccurate to me. the thing about goretex typically getting infected was way off good luck with your surgery though, whichever material you choose Link to comment Share on other sites More sharing options...
milkyway52 Posted January 26, 2011 Share Posted January 26, 2011 This is the first time participating a forum for very long time. This is kinda fun. Haha Anyways, JoAnn said that silicon is very hard to predict when the infection will happen, but it will happen. It can last between 6 months - 10 years. But whether if it's gortex or silicon I guess it really depends on the surgeon?? For me I'm trying to go for the method that will require little to no revision at all in the future, so I'm looking at rib cartilage. But I'm still a little bit skeptical with the idea of taking parts from my rib bone. Is silicon, gortex and rib the only option for nose bridge? Link to comment Share on other sites More sharing options...
kain Posted January 26, 2011 Share Posted January 26, 2011 pretty much. asians usually don't have enough septal cartilage for aumentation. there is medpor. it is hard like bone and has a pore size of 400 microns (goretex has a pore size of ~1 micron according to one website). there is injectable fillers, permanent and temporary versions, but i wouldn't risk it as it has been around for ~less than a decade. also, since it is injectable i think it would actually be really hard to remove. i have seen some pics of people who had nose jobs using a piece of their skull from the back of the head... there is diced cartilage wrapped in fascia (idk what fascia is) there is donor cartilage edit: i did some more research and goretex has a variable pore size depending on the manufacturer and its purpose. the pore size for heart surgery is larger because it is supposed to mimic blood vessels etc Link to comment Share on other sites More sharing options...
perfectangle Posted January 27, 2011 Share Posted January 27, 2011 My cousin had a rib rhino done 10 years ago with the same doc as me, his has not warped, though he does think it is a little too high for his liking. Link to comment Share on other sites More sharing options...
perfectangle Posted January 27, 2011 Share Posted January 27, 2011 I had two surgeries. First one was 12 yrs ago with ear cartilage and it left my tip round and bulbous so I got rib for the second one, which has now warped (signs of warping started showing after 6 years). My revision (3rd surgery) is actually today in 6 hours...eek!!!! I'm sooooo nervous and scared, I can't sleep. I will keep you guys posted when I'm able to. Link to comment Share on other sites More sharing options...
catlover88 Posted January 27, 2011 Share Posted January 27, 2011 Saw this in the Anil Shah website - "If there is costal cartilage available in a patient over forty, typically the cartilage is calcified or harder. While this is harder to carve, it often means that the cartilage will warp less INTRAOPERATIVELY." Hmm - wonder if this means the tendency to warp is age dependant??? How about resorption rate? Let's ask our docs and see what they say.http://www.shahfacialplastics.com/costal%20cartilage%20grafting.html His website has a lot of info, recommended to take a look Link to comment Share on other sites More sharing options...
catlover88 Posted January 27, 2011 Share Posted January 27, 2011 Wish you the best of luck. Link to comment Share on other sites More sharing options...
perfectangle Posted January 27, 2011 Share Posted January 27, 2011 Many doctors that I consulted said that goretex is hard to remove due to it being porous. My doctor said that silicon has high probability of rejection because the nose skin is relatively thin (as opposed to other areas such as breast and chin, etc) Also the nose is highly used (meaning when you smile, raise your eyebrows, etc.) it can cause the area to move, and rub and eventually extrude. I've heard mixed stories about silicone. I had another cousin who had hers come out of her nostril, but also know an aunt that has had hers for over 30 years! It all depends on your body too. It sucks because you never know how your body will take things until you actually just do it. And yes, Asians tend to have less septal cartilage, and especially more so in southeast Asians. Another thing My doctor said today is that a lot of surgeons who aren't as experienced will not use septal cartilage, because it is much harder to harvest than ear cartilage or even rib. If you think about it, it really makes sense, cause septal cartilage is usually harvested through small opening (I'm doing closed procedure) as opposed to a more visible area such as the back of the ear. Fascia is a 1-2mm thin membrane found underneath your skin on the back of your head. depending on which part of your head it is grafted from. The part right behind the ear provides thicker fascia, but not as even and smaller, further into your hairline, the fascia is thinner but more uniform than fascia from right behind your ear. It is used to drape and smooth out bumps and can also provide slight augmentation. It is also good for those who have thin skin like me. It also makes the implant/graft appear softer and more natural looking. Link to comment Share on other sites More sharing options...
dorkiegirl Posted January 27, 2011 Share Posted January 27, 2011 omgomg!! good luck PerfectAngle!!! Link to comment Share on other sites More sharing options...
dorkiegirl Posted January 27, 2011 Share Posted January 27, 2011 u guys, after doing more research, I might end up just getting combination nose surgery, silicon bridge+ ear cartilage tip. and maybe wrap the silicon bridge with fascia. there are risks with all of the materials (implant or autologous tissue). soooo many people go with Silicon, and revisions are extremely easy, and with Rib, not all are satisfied, and the revisions are difficult, not mentioning the additional scar from the rib. it only makes sense that the doctors that had dealt with silicon for the past 20 years are now better than before at preventing problems in the future. for example, they came up with using fascia to wrap the silicons for a more natural look, and they almost completely stopped using L shaped silicon. Link to comment Share on other sites More sharing options...
dorkiegirl Posted January 27, 2011 Share Posted January 27, 2011 Dr.Jack Gunter, has devised a technique in which the larger grafts, the dorsal onlay graft and the columellar strut, are reinforced with a centrally placed Kirschner (K)- wire to decrease warping and provide a more stable and predictable result. "Graft warping can occur in autogenous rib cartilage and lead to long-term postoperative distortions of nasal shape. The use of stabilizing K-wires placed through the center of these grafts has been a successful technique to counterbalance the tendency of the grafts to warp. To avoid warping of smaller grafts, we follow the principle of carving balanced cross-sections originally described by Gibson and later substantiated by Kim et al"http://noserevisionsurgeryandsurgeons.blogspot.com/2010/11/techniques-used-to-lessen-degree-of-rib.html readd ^^ sounds interesting, i wonder if Korean surgeons do the K-wire thing for the rib graft. Link to comment Share on other sites More sharing options...
rawdude Posted January 27, 2011 Share Posted January 27, 2011 i guess all methods got its pros n cons. its all about WHAT U DO WANT TO ACHIEVE. the requirements for your nose. and the condition of your current nose. silicone is the easy way in n easy way out and higher chance of getting infected( depends on your requirement, beauty vs risk factor) goretex gives more "natural" < again natural is oso subjective ( depends on what u want for your nose really), harder to remove doesnt mean its ALOT harder or its impossible. just harder but u know its like silicone= maybe 2 procedures; goretex= maybe 3-4 procedures ( just an analogy), then again how easy to remove( depends on your nose condition/requirements too!) <ultimately we wont want any revision at all! according to various posts here and there; ppl who had foreign implants have higher tendencies of revision in few years down the road. ( that doesnt neccesary means foreign implants r causing them! everyones body reacts differently and is all abt aging and your personal habits/lifestyle) henceforth; fans of RIB methods becuz it was "believed" that it has the least complication/infection rate among the rest; its also the tougher way in and tougher way out; requires superb skill of the surgeon to "craft the rib" to your likings not to mention correctly being placed and secured to minimise warping and other complications( then again its also about our individual body reactions and acceptance to it). all i wan to say is; if you r going to silicone or goretex or mix, and if u r going to do something drastic; be mentally and financially prepared for revision years down the road. if u r going for RIB; just make sure the doctor know wat he is doing as long as we dunt get extra RIBS sewed back to our heads! and about absorption and warps.. i have only 2 words for myself and you; GOOD LUCK Link to comment Share on other sites More sharing options...
rawdude Posted January 27, 2011 Share Posted January 27, 2011 dr lee from VIP can do K wire. and so does many other surgeons. its not rocket science, K-wire or Kirshner wire is a very small steel pin with drilling tip that is used to fix the severely deviated nose structure according to joann. well, again; WIRE. another foreign object means defeat purpose of RIB as your own tissues. unless desperately required. guys; i think most of u guys noses are not as ugly or bad as u think; y risk yourself doing all these? i would recommend u guys to stay as natural as possible unless u are confident that even your nose get infected or wrapped in future; it will still look better than your current. -.- BTW: dr lee from vip was understudy of dr gunter.. are they the same gunter? bang! dunt do nose job unless u are desperate. my 2 cents Link to comment Share on other sites More sharing options...
rawdude Posted January 27, 2011 Share Posted January 27, 2011 btw, anyone knows if theres any way we can get to know how competent is the surgeon? say; how many legal suits against him if any or his practice history? or even complains? any local authorities or we can email the plastic surgery association or something? bring along a lawyer to the consultation? some reassurance from a non biased party to confirm ? hmmm Link to comment Share on other sites More sharing options...
rawdude Posted January 27, 2011 Share Posted January 27, 2011 well ull get to sleep soon, just remb to wake up Link to comment Share on other sites More sharing options...
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