Significant nasal augmentation is needed in certain ethic aesthetic rhinoplasties as well as in reconstruction of saddle nose deformities that have occurred for a variety of reasons. To be effective such augmentations requires the material needed to do it. In most cases the augmentation material of choice comes down to either a rib graft or an implant.
While there are advocates for each nasal augmentation material as well as their own advantages and disadvantages, the use of an implant is the only option to avoid a donor harvest scar. Implant material choices come down to either silicone or ePTFE. While silicone nasal implants are more commonly used in the U.S., ePTFE (aka Goretex) is far more frequently implanted in China. These geographic differences are a result of greater familiarity of nasal implant augmentation in Asia where the procedure is performed far more frequently and is often viewed as the preferred augmentation rhinoplasty approach.
One aesthetic problem with silicone nasal implants in some men is that their width can be too narrow. If the nasal implant is not wide enough it will end up appearing as a skinny and abnormal looking ridge running down the center of the nose.
This is almost never an issue with ePTFE because they are available in block form which must be carved to shape. As a result they have more than adequate height and width for any amount of nasal augmentation. In the carving phase the differences in their geometries is apparent, most notably having adequate width down through the middle vault to being the nasal tip.
ePTFE nasal implants have the advantages of developing soft tissue adhesion as well as not being an extremely firm material. These are good characteristics for an implant when it is being tasked with provide a strong push on the overlying skin.
Dr. Barry Eppley
Indianapolis Indiana