It is the most widely used material worldwide for raising the dorsum.
The association is so direct that "rhinoplasty" brings "silicone" to mind.
I often see it taken for granted that silicone will be used.
In rhinoplasty, this is a highly inappropriate and even dangerous notion.
For example, even in rhinoplasty whose goal is not to raise the bridge, such as dorsal hump correction or deviated nose surgery,
I see many patients in whom silicone was used even in such rhinoplasty.
When such patients come for a revision consultation and are examined, we often find that the silicone
In many cases it has been of no help at all and has instead caused side effects.
In fact, having seen many side effects from silicone and artificial materials over years of revision rhinoplasty,
I had long wanted to organize this systematically and present it someday.
So today, under the title "Reasons I Dislike Using Nasal Silicone (in Rhinoplasty)!",
I have prepared case studies on each of the side effects.
1. Silicone breaking through the skin of the nasal tip or the mucosa inside the nose due to physical pressure
2. Acute or chronic inflammation 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. Deformity of the tip cartilages caused by silicone extending to the tip
6. Calcium deposits on the silicone causing bumpy protrusions on the dorsum
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.
Calcium Deposits on the Silicone Causing
Bumpy Protrusions on the Dorsum (Calcified Silicone)
Silicone implants induce calcification whether or not inflammation is present,
and as time passes the likelihood of calcification rises and its area and size grow in proportion.
As calcification progresses, the silicone gradually hardens and warps.
The degree of calcification is not necessarily proportional to the degree of contracture.
Calcification appears in more than 50% of patients who have had augmentation rhinoplasty with silicone,
and as a result the silicone warps and hardens.
Because calcified silicone has a bumpy surface,
the skin becomes very thin and surface irregularities appear,
and at times this even leads to skin perforation.
Calcification of silicone therefore greatly increases the likelihood of side effects.
PH
62-year-old woman. Augmentation rhinoplasty with silicone more than 30 years earlier
P/E
Hard, sharp, bumpy irregularities were palpable on the dorsum
The skin had thinned to the point that perforation appeared imminent
OP
The silicone and capsule were removed
The irregularities of the dorsum disappeared, and the thinned skin regenerated and settled naturally.
The depressed area of skin at the center of the tip also returned to normal.
PH
Woman in her 50s. Simple augmentation rhinoplasty with silicone 30 years earlier
CC
She wanted removal because of pressure, tightness, hardness, and irregularities on the dorsum
OP
The silicone, capsule, and calcified tissue were removed
The dorsal skin, thinned by calcification, showed slight pigmentation after removal, but this gradually fades.
PH
Woman in her 50s. She had simple augmentation rhinoplasty using silicone through an incision inside the nose 25 years earlier
CC
She wanted removal because of pressure, tightness, and similar symptoms on the dorsum
P/E
The dorsum had irregularities, and hard calcium deposits had left the nose rigidly fixed.
OP
The silicone, capsule, calcified material, and the like were all removed through an incision inside the nose.
There is slight swelling and bruising, but the nose that had been hard and fixed has become soft and supple.
The unnatural look caused by the dorsal irregularities and straight-line nose has changed to an attractive, well-aligned appearance.
