Resolving Plastic Surgery Side Effects: Case 03 [Nasal Silicone Removal via Closed Approach]

Do difficult surgeries cause more side effects?Or is it the most commonly performed surgeries that cause more?

Here, “plastic surgery side effects” refers to cases in which the result of plastic surgery is not a normal one;

please understand it as a blanket term for any unwanted problem that has appeared.

What Are “Plastic Surgery Side Effects”?

Plastic surgery side effects are cases in which a cosmetic surgery or treatment leaves behind inflammation, nerve damage, deformity caused by anatomical changes, functional impairment, and the like. 

In other words, when a surgery or treatment leaves, cosmetically or functionally, an unwanted result or an abnormal result that does not usually occur, it is collectively called a “plastic surgery side effect,” and this is also a situation that calls for secondary or revision surgery.

So, among those who visit our clinic for revision surgery,  which plastic surgery side effects are seen most often,

how can they be prevented, and how should secondary surgery to correct them be carried out? Let us take a look.

During consultations about tip cartilage repositioning performed together with nasal implant removal,
patients often ask, "What is cartilage repositioning, and is it really necessary?"

After we explain why cartilage repositioning is needed and why it matters,
"Doesn't cartilage repositioning require an open approach?" is the question that follows.

Results may vary with the surgeon's level of skill,
but at our clinic, cartilage repositioning and nasal implant removal are performed through a closed approach in more than 90% of cases.


In addition, many patients want the implant, grafted cartilage, foreign material, and the like
all removed but hesitate over surgery for fear of side effects or deformity after removal.

Chief Complaint

 ·The silicone implant moves, its outline is visible, and it is off-center·A tingling sensation on the dorsum·Asymmetric nostrils·The eyes appear close-set

Past History

Silicone augmentation rhinoplasty 20 years ago (closed approach); silicone + ear cartilage 15 years ago (open approach)

Physical Examination

·The implant is deviated diagonally and has migrated upward, making the glabella high
·The implant is wide, giving a masculine appearance
·At the tip, the implant tilts to the right, with asymmetric nostrils and a tilted columella
·Because of contracture, the outline of the implant is visible and the skin is stiff The surgery was performed through a closed approach;
the silicone, capsule, tip cartilage graft, and other materials were all removed, and then tip cartilage repositioning was performed.


In the frontal view after surgery, no dorsal irregularity, skin damage, upturning of the tip,
or collapse of the dorsum or tip can be seen at all. After removal of the nasal silicone implant and tip cartilage repositioning,
the asymmetric nostrils and tilted columella have also become completely symmetric. In the lateral view before removal, there appeared to be a convex hump,
but in the lateral view after removal, the dorsal line is straight and well shaped.


 The nasal tip has not collapsed but has become more defined.
The columella, which had been bent, is smoothly connected after removal. When the height of the nasal tip has been raised excessively using a septal extension graft, columellar strut, or the like,
the likelihood that the tip cartilages will become deformed is very high.
In this patient as well, the tip was severely deformed, so the septal cartilage grafted to the tip, the septal extension graft,
the columellar strut, and other materials were removed and tip cartilage repositioning was performed. From below as well, the columella, which had been tilted, can be seen to be straight,
and the asymmetry of the nostrils has been completely corrected. In the lateral view as well, the shape of the nasal tip, which had looked as if it were about to protrude,
can be seen to have returned to a gentle, soft shape. The silicone implant had broken through inside the nose, and the nose was swollen overall from severe infection,
with contracture in progress.

The silicone, capsule, infected tissue, and other materials were thoroughly removed, and tip cartilage repositioning was performed.  After removal of the implant that had extruded in the right nostril, the granuloma, and the scar tissue,
the overall shape of the nose, including the nostrils, nasal bridge, and columella, was corrected,
and natural left-right symmetry was achieved.