Silicone rubber (Silastic) |
Rubber elastomer, well-tolerated and easily customizable, soft pliable consistency; indications: chin, lateral jaw, cheek, and nose augmentation |
CT: variable attenuation, usually denser than soft tissue, but less dense than bone and best discerned using bone windows; |
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MRI: very low signal intensity on T1- and T2-weighted sequences |
Expanded polytetrafluoroethylene (Gore-Tex) |
Biocompatible, long-lasting but can be removed surgically; indications: lower face lift, nasal and forehead augmentation |
CT: higher attenuation relative to soft tissues, but less dense than bone; |
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MRI: hypointense to fat on T1- and T2-weighted sequences |
Polytetrafluoroethylene (Teflon) |
Obsolete |
Imaging features similar to those of Gore-Tex |
Porous polyethylene (Medpor) |
Inert and biocompatible, low complication rate, permanent; indications: lower face and nasal augmentation; also used for orbital and auricular reconstruction; fibrovascular ingrowth can render removal difficult |
CT: attenuation between fat and water; |
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MRI: hypointense to fat on T1- and T2-weighted sequences; enhancement may occur due to fibrovascular ingrowth |
Hydroxylapatite |
Inert and biocompatible; blocks of hydroxylapatite can allow fibrovascular ingrowth and bony incorporation |
CT: hyperdense, hyperattenuation similar to that of bone; the implant can become incorporated into and inseparable from the adjacent bone; |
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MRI: low signal on T1 and T2; enhancement may occur due to fibrovascular ingrowth |
Bone |
Occasionally used for rhinoplasty, cheek, and chin augmentation; harvest sites include iliac crest, cranium, turbinates, rib |
CT: same as normal bone elsewhere; cortex and trabecular can be identified unless resorption has occurred |
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MRI: high T1 and T2 marrow signal and low-signal cortex are often discernible; in the early postoperative period, marrow edema within the graft may appear as low T1 and high T2 signal |
Cartilage |
Often used in rhinoplasty and sometimes chin augmentation; harvest sites include nasal septum, conchal cartilage, and costal cartilage; can be part of osteochondral grafts; can be diced and wrapped in Surgicel (Turkish Delight) |
CT: soft-tissue density; may form a rim of calcification or ossification; |
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MRI: usually low T2 and high T2 signal |