Key points
- Silicone implants are described as the most widely used material for rhinoplasty to raise the bridge of the nose in Asian countries [1].
- East Asian noses often have a low bridge, little septal cartilage, and thick soft tissue, and methods for building up the bridge have been developed with these features in mind [2].
- In Western countries, synthetic materials are often not recommended because of concerns about infection and implant extrusion, and complication rates with silicone vary greatly depending on experience, technique, and implant design [1].
- Your own cartilage is still regarded as the standard for building up the bridge, and methods that combine several materials are also used [3].
- Every material has pros and cons, so the choice should be made with a specialist based on your skin, the structure of your nose, and the result you want [4].
What is silicone implant rhinoplasty?
Rhinoplasty to build up the bridge of the nose (dorsal augmentation rhinoplasty) addresses cosmetic and functional problems caused by a low nasal bridge, and a variety of surgical methods and materials are used [4]. Among them, a silicone implant is a method of raising the bridge by inserting a premade synthetic material.
In Asian countries, rhinoplasty to raise the bridge of the nose is a common cosmetic operation, and silicone implants are described as the most widely used material [1]. Long experience of good results in Asia is given as the reason silicone rhinoplasty is commonly performed there [1].
Why implants have been widely used for East Asian noses
The East Asian nose is described as generally having a low bridge, little septal cartilage, and thick soft tissue covering it [2]. With little septal cartilage, there may not be enough of the patient's own material to raise the bridge, so premade implants have been widely used.
Synthetic implants are still widely used in East Asian rhinoplasty today [3]. However, rhinoplasty in East Asia is described as moving away from the traditional approach of inserting synthetic implants through incisions inside the nose, as new aesthetic standards, techniques, and improved materials have emerged [5].
Why Western surgeons are cautious: infection and extrusion
Synthetic materials have advantages, but in Western countries surgeons often advise against using them in rhinoplasty because of the risk of infection and of the implant pushing through the skin (extrusion) [1]. This regional difference shows that the same material can be judged differently depending on how its risks are weighed.
Complication rates with silicone implants are described as varying greatly depending on the surgeon's experience, the surgical technique, and the implant design [1]. One review considered silicone usable for building up the bridge when precautions are followed [1], and another review concluded that synthetic implants can be used for bridge augmentation if both the patient and the surgeon understand the associated risks [4]. This does not mean the risks disappear, so it is important to watch for warning signs even after surgery.
How does silicone compare with other materials?
Materials for raising the bridge of the nose fall into three broad groups [4]. Each material differs in its properties, uses, and safety, so their pros and cons need to be weighed together [4].
Your own cartilage is still regarded as the standard for building up the bridge, and one review notes that combining several materials can improve results while reducing complications [3]. The authors of a review on bridge augmentation in East Asian patients considered methods using the patient's own tissue, such as rib cartilage or diced cartilage wrapped in fascia, to be generally better than synthetic implants in results, safety, and longevity, but this was presented as the authors' opinion [2]. Among synthetic materials, expanded polytetrafluoroethylene (ePTFE) is described as increasingly used in East Asian rhinoplasty [5].
- Your own tissue: septal cartilage, ear cartilage, rib cartilage, bone, and soft tissue
- Donor tissue and substitute materials: irradiated or non-irradiated donor rib cartilage and acellular dermis
- Synthetic implants: silicone, ePTFE, and others
Why the nasal tip and surrounding area are assessed together
Rather than only raising the bridge, an approach that also considers the nasal tip and the harmony of the whole face is emphasized. Nasal tip surgery using the patient's own cartilage, performed along with bridge augmentation, is described as a recent trend in East Asian rhinoplasty [5].
When the front of the upper jaw below the nose (premaxilla) is sunken, the angle between the nose and the lip can become narrower and the tip can look droopy. Mild cases are described as being correctable with synthetic implants, the patient's own tissue, fat grafting, or filler [6]. Because a bridge implant alone sometimes cannot achieve the look you want, it is a good idea to have the structures around the nose examined as well.
What to ask during your consultation
For bridge augmentation in East Asian patients, an individualized approach that chooses the method based on personal factors such as skin quality, anatomy, and the desired result is emphasized [2]. It is important to confirm through a preoperative evaluation that your goals are appropriate [2].
- Your skin thickness, bridge height, and how much septal cartilage you have
- Whether silicone, your own cartilage, or a combination of materials is recommended, and why
- The shape and size of the implant, and whether tip surgery will be done at the same time
- The possibility of complications such as infection and extrusion, and their warning signs
- The plan for implant removal or revision surgery if a problem occurs
Frequently asked questions
- Once a silicone implant is placed, does it last indefinitely?
- The research summaries used for this article did not include figures showing how long silicone implants last without problems. Long experience of good results in Asia has been described [1], but risks such as infection and extrusion are also mentioned, so it is best to keep having follow-up checks after surgery [1].
- Which is safer, silicone or my own cartilage?
- Your own cartilage is regarded as the standard for building up the bridge [3], and some authors considered the patient's own tissue to be generally better than synthetic implants [2]. On the other hand, one review concluded that silicone can also be used for bridge augmentation when precautions are followed [1]. Each material has pros and cons, so the decision should take into account both the condition of your nose and your risk factors [4].
- What affects the risk of complications with an implant?
- Complication rates with silicone implants are described as varying greatly depending on the surgeon's experience, the surgical technique, and the implant design [1]. If you notice redness, worsening pain or swelling, or the implant starting to show through the skin after surgery, seek care right away.
References
- Kim IS. Augmentation Rhinoplasty Using Silicone Implants. Facial Plast Surg Clin North Am. 2018.PubMed 30005785DOI
- Frederick JW, Yoo DB. Asian Augmentation Rhinoplasty. Facial Plast Surg. 2025.PubMed 40389234DOI
- Ho OYM, Ku PKM, Tong MCF. Rhinoplasty outcomes and trends. Curr Opin Otolaryngol Head Neck Surg. 2019.PubMed 31232719DOI
- Fisher M, Alba B, Ahmad J, et al. Current Practices in Dorsal Augmentation Rhinoplasty. Plast Reconstr Surg. 2022.PubMed 35259145DOI
- Li D, An Y, Yang X. An Overview of Asian Rhinoplasty. Ann Plast Surg. 2016.PubMed 27404467DOI
- Shokri T, Wang W, Cohn JE, et al. Premaxillary Deficiency: Techniques in Augmentation and Reconstruction. Semin Plast Surg. 2020.PubMed 32390776DOI
This article is an English translation of general health information that DOY JUN Plastic Surgery compiled in Korean from the summaries (abstracts) of papers in international academic journals. Treatment methods and results vary depending on each person's condition, so please consult a specialist for an accurate diagnosis and treatment plan.
