Horror stories about the use of silicone implants in nose lifts are not exactly few
and far between. While it remains to be the most popular implant for nasal
augmentation in Third World countries, more and more people are now looking at
safer options. It is precisely the countless cases of material rejection, nasal
contraction and other complications that dictate the shift in the trend.

Nose jobs peddled for a measly cost of less than P15,000 are to be blamed for
chronic inflammation of the tissues, manifested by a reddening of the skin; or
the bridge of the nose flattening out and becoming wider, just to mention a few
of the many side effects. The culprit—silicone injection.

Silicone can be a curse in disguise. Patients usually don’t develop immediate reaction
to the implant and will find very satisfying cosmetic results during the first
years. The idea is quite appealing to people who are after instant
gratification and who unreasonably scrimp on matters that impact on their
safety. While problems may not manifest themselves sooner, it will surely come
later. And what victims would initially think of as a steal—easy-on-the-pocket
initial cash outlay—will surely turn out to be costlier. They would end up
spending more for damage control.

Dr. Levi Lansangan of Shimmian Manila Surgicenter, a certified facial plastic
surgeon, whose expertise was sought to consult and repair the nasal deformity
of one of the victims states, “Silicon oil, otherwise called as DMPS is
actually a motor oil. There is no such thing as medical grade silicone oil. Due
to many complications which are far worse than the use of silicon block—such as
extrusion, infection, migration and unpredictable results—there is no approved
medical indication for this material except in cases of retinal detachment.”

So what’s wrong with silicone? Why can’t it be a safe nasal augmentation material?
A closer look at our nasal anatomy will reveal a compelling argument why
silicon implants hardly work. Our nose has two joints, one connecting the
cartilage with the bone and the other one connecting the alar cartilage with
the upper cartilage. These joints allow free movement of the nose from left to
right, upwards and downwards. If we place a hard silastic silicone implant
above these structures, the joints will be fixed and any medium velocity force
to the nasal area can lead to resulting trauma, much like placing a nail over
the nose.

True that most of the patients augmented with a silicone implant are clearly
asymptomatic for many years. However there is a growing evidence nowadays on
the deposition of calcium crystals on a prolonged implant. In this case, to
ensure safety, another surgery may be necessary to remove and examine the
calcifications.

A member of the advanced rhinoplasty research team in Asia and the author of
“Sub-Nasale Flap” published recently in Plastic Reconstructive Surgery Journal,
Dr. Lansangan says, “Cartilage implant is still the best. It is safe,
rejection- and worry-free. The only thing going against it is its cost
particularly when it comes to bridge augmentation where irradiated or autologous
rib cartilage harvest is required. It’s just too prohibitive. Sure, the market
for nasal enhancement is growing. But it is also becoming more and more price
sensitive. The next best option which offers the same safety level is
Gore-Tex.”

This 1958 discovery represents one of the most recent significant advances in nasal
augmentation. Gore-Tex’s usefulness was originally found in pulmonary and heart
valve operations because of its strength, biocompatibility and ability to carry
blood at arterial pressure, leak-free. Seventeen years after its discovery, FDA
approved of its expanded use as replacement for human tissue in facial surgery
including nose lift.  

Gore-Tex has all the primary properties one would look for in a good implant material.
It allows normal facial contours after surgery and encourages rapid tissue
growth within and through it. Unlike with silicone wherein tissues simply
encapsulate through it, healing with Gore-Tex happens through tissue
incorporation thereby helping anchor the implant in the treated area. This
ability to incorporate allows our body to treat it as something not foreign
thus eliminating material rejection, eventual contractions and other
complications.

Lorraine, a 37-year-old mother of two, attests “Gore-Tex is amazing! I had a contracted
nose because of silicone implant I’ve had for 10 years. My nose looked fine,
initially, but then almost everybody could tell I had a nose job.”

One trip to Korea and a chance to meet a friend later, she learned about Shimmian
Manila Surgicenter. “Back in the Philippines, I had a revision rhinoplasty
using Gore-Tex implant” Lorraine narrates. “My nose was restored without any
traces of previous complications. It looks even better because it looks so
natural. Just perfect for my face.”