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Removing Gore-Tex implant

Silicone is the most widely used alloplastic implant for dorsal augmentation. Gore-Tex, an expanded polytetrafuoroethylene, is also a commonly used material. Unlike silicone implant, Gore-Tex is soft and feels natural. It has micropores, so tissue grows inside and the implant is fixed to the tissue.

While Gore-Tex has many advantages, its disadvantages are also distinct. Firstly, it can erode nasal bone a little when the implantation duration is long. Erosion causes pain and heaviness on the dorsum. It is common to see a 'rail road deformity' after longstanding Gore-Tex removal.
'railroad deformity of the dorsum after Gore-Tex removal'

Second, it is more difficult to remove than silicone implant. Because tissue grows inside the micropores, it adheres to the tissue. If the implant is inserted deep to the radix, sometimes complete removal is extremely difficult. In this case, endoscopic observation of the nasofronta area helps to completely remove the silicone pieces.

Third, if it is infected, removal is the only answer because micropores harbor bacterial organisms. The size of the micropore do not permit the entering of the white blood cell, which is a main killer of microoragnism. On the other hand, small microorganisms can easily enter the pores and cause infection. When infected, early removal is important because it can cause tissue damange, especially the nasal skin. When the skin is damanged, complete restoration is almost impossible.

Hopefully, most deformity after Gore-Tex removal can be successfully restored with autologus tissue. Only autogenous material can permanantly cure the deformity while using another alloplastic material makes another potential source of future disaster.


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