Nose Surgery Implant Types: Artificial, Autologous, Allogeneic Tissues... Let's Understand the Basics

One of the first considerations when undergoing nose surgery is deciding which material to use. While implants used in the nose are generally safe and elicit minimal tissue reaction, each material has its own advantages and disadvantages, and the choice depends on the patient's condition.

Although many new materials are being developed and introduced for nose surgery, they are broadly categorized into artificial implants, autologous tissues, and allogeneic tissues. It is not wise to blindly trust autologous tissues simply because they are from one's own body, nor is it true that implants are inherently unsafe. Therefore, it is prudent to understand the basics and make a decision in consultation with a specialist.

What is particularly important is which surgical method and type of material are applied to which type of nose. Today, I will briefly introduce the various implant materials used in nose surgery for different situations.

Nose Surgery Artificial Implants

Silicone

This is the most commonly used implant in nose surgery. Approved by the U.S. FDA, it is harmless to the human body, does not change or get absorbed, and has the advantage of allowing for more precise shaping compared to Gore-Tex. Occasionally, if the skin is thin, it may be visible, so it is primarily used for patients with thick skin and a low nose.

Gore-Tex

Gore-Tex is a fibrous material that is very soft and adheres to surrounding tissues after insertion, preventing movement post-surgery. It has been used in the surgical field to create artificial blood vessels, and nowadays, it is widely used as a nose surgery material that can replace silicone. Compared to silicone, Gore-Tex has a softer feel due to its microporous structure, but it also has the disadvantage of potentially settling slightly over time after implantation. This implant is suitable for patients with thin skin or for surgeries focusing on the bridge of the nose rather than creating a sharp nasal tip.

Medpor

Medpor is an implant often called ‘artificial bone’ and is primarily used in noble line surgery, temple augmentation, and chin augmentation. Due to its material, it can feel harder than other materials.

Nose Surgery Autologous Tissue Implants

Ear Cartilage

This is the most commonly used autologous tissue material in nose surgery, primarily for nasal tip surgery. It also serves to protect the skin from the implant placed in the nose.

Septal Cartilage

This is the firm, thin wall of cartilage located between the two nostrils, primarily used for significantly raising the nasal tip or for nasal tip extension in short noses.

Rib Cartilage

The cartilage from the front part of the 6th to 8th ribs is used. It is the most important material in nose surgery using only autologous tissue and is primarily used when septal cartilage is insufficient in short nose surgery.

Dermal Fat Graft

Autologous dermal fat tissue can be used for patients who wish to avoid implants, those who have undergone multiple surgeries resulting in insufficient subcutaneous tissue in the nose, or those who have experienced severe inflammation previously. It is considered the safest tissue for raising the nasal bridge, but about 30-40% of it is absorbed within the first year after implantation. Therefore, a relatively large amount must be implanted during surgery to account for the reduction in volume after several months. This means that for a few months post-surgery, the nose may appear larger than expected and look awkward. Given the nature of cosmetic surgery, which aims for quick naturalness and less visible surgical sites, despite its excellent material quality, it is not commonly used.

Nose Surgery Allogeneic Tissue

Allogeneic tissue refers to tissue from another person that is identical to one's own tissue, excluding immunological differences.

The most representative example is AlloDerm. Since it is best to perform surgery with a material comparable to autologous tissue, autologous cartilage and AlloDerm are most frequently used. AlloDerm is a material processed from human dermis through special treatment. Unlike artificial implants, it is soft without foreign body reaction and effective in creating a smooth nasal bridge or tip.

As such, there are various implants used in nose surgery beyond the commonly known silicone, each with its own advantages and disadvantages, and each used for different surgical methods or areas. Therefore, rather than considering any particular material as superior, the choice of material varies depending on the patient's condition, surgical site, and method. Thus, thorough consultation with a specialist before surgery is paramount.

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