Resolving Plastic Surgery Side Effects: Case 04 [Silicone Implant Removal in a Contracted Nose]

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.  Among those who have visited Won-Suk Kook Plastic Surgery to resolve plastic surgery side effects,

of patients who visited Won-Suk Kook Plastic Surgery to resolve plastic surgery side effects.
many had rhinoplasty with a silicone implant and, over time, saw the nose gradually turn upward

and harden, a condition known as contracture; it is reported in about 30% of cases. Correction of the Contracted Nose


When the contracture is not severe, removal of the implant and capsule with tip cartilage repositioning alone can correct it.


When the contracture is severe, however, along with removal of the silicone and capsule,
nasal lengthening using autologous cartilage (costal, ear, or septal cartilage) is necessary.

This is a 31-year-old female patient who, 12 years earlier at another clinic, underwent open rhinoplasty with silicone augmentation

and a strut of septal cartilage placed to support the nasal tip.

PH
 

·12 years ago: open rhinoplasty with silicone augmentation of the dorsum and a septal cartilage strut to support the tip

Chief Complaint

·The silicone implant on the dorsum is shifted to the left, the columella and tip are tilted, and the nose is contracted with an upturned tip.


Physical Examination

·Because of the silicone, the dorsum and tip look crooked and the implant is visible externallyBecause of contracture, the tip cartilages have been pulled upward and the nose appears upturned Before surgery, the dorsum and tip were tilted and the silicone was visible externally.

After silicone removal and cartilage repositioning, both the dorsum and the tip sit straight.

The nostrils, which had been conspicuous from the front because of contracture, are also much better covered. From below as well, the nasal tip and columella are clearly straighter and look natural. As the nasal tip, which had been lifted by contracture, came down,

the nose became longer, and the nasal bridge now runs straight. Before removal of the silicone implant, the nasal tip was markedly upturned because of contracture.

After implant removal, the tip has come down considerably, lengthening the nose,

and the nasal bridge also runs straight.



The nasolabial angle also decreased by more than 10 degrees and the nasal tip became more defined;

this shows that cartilage repositioning, in which the tip cartilages that had been pulled upward are dissected

and restored to their original position, was effective. When contracture has progressed over a long time, the nose is severely upturned,

and the skin is tightly constricted, nasal lengthening using autologous cartilage is needed

to restore a natural dorsal line and a nose of sufficient length. After removal of the silicone and capsule and nasal lengthening with autologous cartilage, in the frontal and three-quarter views,

the previously excessive nostril show has returned to a normal degree. In the lateral view as well, the upturned tip has come down naturally.

Because of contracture, the skin that had been pulled tight has also relaxed, and the soft feel of the nose has been regained.