Reasons I Dislike Using Silicone in the Nose #2 (Nasal Implant Removal / Nasal Silicone Removal / Revision Rhinoplasty)

Silicone implants remain, in Asia and

worldwide, the most widely used material for raising the dorsum.

The association is so direct that "rhinoplasty" brings "silicone" to mind.

In Asia in particular, when it comes to "rhinoplasty," both doctors and patients

are often seen to take the use of silicone for granted.

This is a very inappropriate and even dangerous notion in rhinoplasty.

For example, even in rhinoplasty whose goal is not to raise the bridge, such as dorsal hump correction or deviated nose surgery,

we see many patients in whom silicone was used.

When such patients come for a revision consultation and are examined, we often find that the silicone

did nothing for the shape or function of the nose and instead caused side effects.

In fact, having seen many side effects from silicone and artificial materials over years of revision rhinoplasty,

I have long wanted to organize and present them systematically.

 So today, under the title "Reasons I Dislike Using Nasal Silicone (in Rhinoplasty),"

I have prepared case studies on each side effect.

Side Effects Caused by Silicone Implants After Rhinoplasty

• 1. Silicone breaking through the skin of the nasal tip or the mucosa inside the nose due to physical pressure
• 2. Acute or chronic infection caused by silicone or artificial materials used with it
• 3. Contracture due to capsule formation and inflammation
• 4. Silicone repeatedly becoming crooked even after corrective surgery
• 5. Tip cartilages deformed by silicone that extends to the nasal tip
• 6. Calcium deposits on the silicone making the dorsum protrude unevenly
• 7. Dorsal skin thinning and turning red, with the silicone showing through
• 8. Recurrent hematoma in the dorsum (inside the silicone capsule)

The probability of side effects after rhinoplasty with a silicone implant differs somewhat

among the published papers, ranging fairly widely from 4-36%.

The difference arises from when the side effects were diagnosed.

The most common side effects are contracture (34.8%), implant deviation (30.1%),

inflammation (10.1%), skin thinning (19.9%), and extrusion through a perforation (5%).

This case study will continue as a series of 8 parts, and we hope you will follow it.

From Silicone and the Artificial Materials Used With It:

Acute and Chronic Infection

The patient underwent augmentation rhinoplasty with silicone 2 years earlier.

After surgery the nose swelled and gradually turned upward, and infection accompanied by contracture was suspected.

The silicone, capsule, and infected tissue were removed through an incision inside the nose.

Infection caused by a silicone implant can be classified as acute or chronic.

Acute infection generally develops within one month, but when silicone is in place, there may be no particular symptoms for a long time

before it suddenly develops into an acute infection with swelling, redness, and pain.

The pre-removal photos show that the dorsum was swollen and that discharge had collected.

After removal, the dorsum looks slim and natural.

The tip, which had been upturned and bulbous, has also become slimmer and come down.

The patient reported having had rhinoplasty 4 years earlier with silicone plus ear cartilage at the tip (open approach).

Starting 2 years earlier, the glabella area had bulged like a cyst and became swollen and red whenever she was tired,

and 1 month earlier something began to protrude at the tip, which turned red and painful, and an abscess had formed at the tip.

The patient reported having had rhinoplasty on 3 occasions using silicone, septal cartilage, ear cartilage, AlloDerm, and other materials.

Nasal obstruction was severe, the tip had turned red, and pus had collected at the tip.

The silicone and cartilage grafts were removed through an open approach.

This is the appearance 1 month after surgery.

Some swelling remains, but the inflammatory reaction that had made the tip red has resolved.