The height and width of the nasal bridge are mainly dependent on the patterns and size of the emplaced prosthesis (nasal implant); therefore, selecting the proper implant for each individual challenges the doctor’s esthetic experience. Currently, all nasal implants offered at WiSH clinic are legal materials approved by the Ministry of Health and Welfare. We prepare a full range and series of various nasal implants in stock so that patients can freely make choices based on Dr. Chuang’s suggestions and requirements.
Silicone Nasal Implant
Refined from a traditional or old-style silicone implant, this modern implant is relatively thin and has an ergonomic design. They are available in an I or L shape as well as various sizes. The advantages of this implant are its easy emplacement and removal and the low price, but the drawbacks are the relatively high risks of infection or foreign body reaction (approximately 5–7%). If emplaced in an inappropriate position, it shows dislocation or looseness easily. Silicone implants may also present capsular contracture or deformities after prolonged use, therefore they are rarely selected by local patients. Generally, these nasal implants are indicated for patients with a narrow bridge base or those who prefer an expected slim and a highly defined nasal bridge as the result.
Link : Silicone nasal implant provided by Implantech
Sili-Tex (Chimera) Composite Nasal Implant
A Sili-Tex (Chimera) composite implant is a new-generation nasal prosthesis produced in the US and is also called a “hard” Gore-Tex nasal implant. It is also available in models I or L. It is composed of hard silicone as the internal scaffold, which is enveloped by Gore-Tex (ePTEF) at a thickness of approximately 1 mm at the outer layer. Therefore, the surface in contact with the human body is Core-Tex rather than silicone. This composite design not only redresses the drawbacks of capsular contracture or foreign body reaction but also has the high biocompatibility and tissue adhesiveness of Gore-Tex, which provides solid and non-deformable nasal bridge support and distinctly elevates the safety and durability of rhinoplasty than the traditional laminar (soft) Gore-Tex material, thus amounting to one of the best prosthesis at present. Moreover, because the coated Gore-Tex surface makes the implant thicker and wider, the bridge shape resembles the congenital bone structure that does not appear exceedingly slim or sharp like the silicone implant, so the results are relatively harmonious and natural. If the prosthesis is to be removed in the future, it is easily taken out via a unilateral intranasal incision instead of cutting the columella incision again like what the traditional laminar Gore-Tex prosthesis requires, and this is surely highly reparable.
Link : Implantech ePTEF composite implants
Bistool Beak-shaped Nasal Implant
It is a refined soft silicone nasal implant produced in Korea and is also available in models I or L. As its appearance is designed like a curved beak, it is also called a beak-shaped nasal implant. Its advantages are the numerous models and sizes (up to 45 types for the entire series), which satisfy the various structures and requirements of a majority of patients, and the time it saves for the modification of nasal implants during the surgery, while its drawback is the utilization of silicone material as the primary component; therefore, foreign body reaction, rejection, infection, or capsular contracture and dislocation may still occur in certain cases. Additionally, because its design is aimed to intentionally sculpt a mild nasal bridge curvature, the implant possibly makes the nasal tip too upturned, which conflicts with local patients’ requirements for the downward compression or elongation of the nasal tip, thus becoming unsuitable for remodeling the projected nose or extending the nasal tip.
Link : Korean Bistool silicone implant
Laminar Gore-Tex Prosthesis
It is a soft single ePTEF material and comes into shape after layers of stacking. The available thicknesses are 1, 2, 4.5, and 6 mm, and physicians select the appropriate thickness for scissoring and stacking in light of the patient’s nasal structure conditions during the operation; it has the highest plasticity and customization degree among all nasal implants. However, its drawbacks include a relatively long operation time and slightly higher risks of postoperative infections than the hard Chimera nasal implant. Besides, the soft Gore-Tex prosthesis may present crooking, unevenness, or shrinkage over time as it is prone to structural changes due to the behavior of its material in the body. Its long-term stability is also inferior to that of the Chimera prosthesis, and an open incision on columella needs to be made for further removal or even small modifications, which makes the revision surgery relatively more complex. Nowadays, the laminar Gore-Tex prosthesis has been mostly replaced by the Chimera nasal implant, and its applications are mainly limited to the reinforcement of the support or height of another nasal implant or the glabellar augmentation in three-section rhinoplasty.
Link : Implantech Gore-Tex products