Several authors from Inha University in Korea including Jang TY, Choi JY, Jung DH, Park HJ, and Lim SC recently published an article in Laryngoscope (March 5th) examining the histology of Gore-Tex implants. Histology is a fancy word for looking at something with a microscope. Essentially, they found that over time, Gore-Tex is infiltrated with neighboring tissue, changes shape, and creates inflammation. More importantly it also creates a foreign body reaction.
While many surgeons continue to use Gore-Tex as in rhinoplasty, I have a long list of patients operated by outside surgeons dissatisfied with Gore-Tex for a variety of reasons. First of all it can become infected. If it does become infected it can lead to serious and permanent contracture of the nose and soft tissue envelope. In addition, many patients with Gore-Tex complain about strange sensations and pain associated with it, which may be related to the foreign body reaction induced. Some surgeons believe that an artificial implant is more stable over time as compared to autogenous implant such as septal cartilage or rib, but Gore-tex changes size and can dissipate per patient experience and this study.
The answer to nasal grafting is that costal cartilage, auricular cartilage, while more technically difficult to work with and require additional time are the safest materials for the patient in a capable surgeon’s hands. The challenge for the patient is to find a surgeon with enough experience in this regard to provide optimal and consistent outcomes.