LAM FACIAL PLASTICS

Hi Dr. Lam,

I'm extremely keen on rhinoplasty but I've a few questions I'd really appreciate you advising me on.

My nose has a very flat bridge, limited septal cartilage and my tip is upturned, broad and flat. Also, my nose tip is very squishy (without bone?) - it's literally just a flap of skin that i can squash any way i want without pain or obstruction. from touch i believe my nasal cartilage/bone ends about 2/3 way down my nose.

In this peculiar instance, should I opt for

1. a goretex implant with ear cartilage grafting for tip
or
2. an L-shape silicone implant

I've read many horror stories about L-shape silicone implants and it's troubling. However, I fear that I would not have sufficient ear cartilage to build up my tip since I'm basically starting from nothing but would prefer a sharp, pointy tip. It seems that L-implants can give me the projection I desire. What should I do?

Thanks for your help Dr. Lam (:

if you want aggressive projection, then a silicone implant can do it. but i hate them. i stopped using them 8 years ago due to problems with shrink wrapping and other complications. i find ear and gore-tex far better. you can still get good projection just not as pronounced and sharp as silicone, which i think is a good thing.

Dear Dr. Lam,

Thanks so much for your quick reply. I was already leaning towards goretex + ear cartilage instead of the L-shape silicone implant due to worries about extrusion and warping, and you really addressed my worries since it's not true that I do not have enough ear cartilage to achieve a good nose tip projection despite my absent nose tip bone.

Thanks once again (:

most welcome.