There is a lot of discussion and concern in the UK at present regarding PIP implants in relation to cosmetic breast surgery. Implants are sometimes required in primary and in secondary rhinoplasty. One of the commonest places to use an implant in rhinoplasty is along the bridge of the nose to build it up if it has been damaged by injury or too much bridge had been removed in a previous surgery or the patient was born with a low bridge. It is more common for patients from Asia to request building up of the nasal bridge. It is very tempting in these cases to use an artificial implant such as Gortex or Silastic which is a type of plastic. These are easy to use as they don’t require extra surgery just the opening of a packet! They can work well but carry an increased risk of infection or rejection. This is a major difference compared with patients own tissue which can’t be rejected and has a much lower chance of infection. Therefore, in the nose if an implant is required I always aim to use the patient’s own tissue. It may take extra time to remove from elsewhere in the body like the rib or the scalp or ear and longer to shape and carve but I feel it is worth the extra effort. Using a patient’s own tissue to build up their own nose is the best principle to follow.