Why I Dislike Using Silicone in the Nose #8 (Revision Rhinoplasty / Nasal Implant Removal / Rhinoplasty Side Effects)
Silicone implants remain the most widely used material for raising the dorsum, not only in Asia but worldwide.
The association is so direct that the word "rhinoplasty" brings "silicone" to mind.
In Asia in particular, I often see doctors and patients alike take it for granted that silicone will be used in "rhinoplasty."
In rhinoplasty, this is a highly inappropriate and even dangerous notion.
For example, I see many patients in whom silicone was used even in rhinoplasty not aimed at raising the bridge, such as dorsal hump correction or deviated nose surgery.
When these patients come for a consultation about revision surgery and are examined, I often find that the silicone has been of no help at all to the shape or function of the nose and has instead caused side effects.
In fact, having seen many side effects from silicone and artificial materials over my long years of performing revision rhinoplasty, I had 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.
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 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. Tip cartilages deformed by silicone that extends to the nasal 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.
On the Dorsum (Inside the Silicone Capsule):
Recurrent Hematoma
1) I often see patients who come in because the dorsum suddenly swelled and bruised several years after augmentation rhinoplasty with silicone.
This occurs when the capsule surrounding the silicone is scratched by friction with the silicone or by impact,
and blood seeps out and collects in the space between the capsule and the silicone.
2) Once the capsule is damaged in this way and a hematoma forms,
it takes considerable time (2-3 weeks or more) to be absorbed and disappear,
and the damaged site bleeds again easily, so hematomas recur.
3) When hematomas recur in this way, an inflammatory response begins,
the capsule thickens, and the likelihood that contracture will begin increases.
4) If hematomas recur several times, removal of the silicone should be considered.
PH
38-year-old woman. She had tip plasty and augmentation rhinoplasty with silicone and septal cartilage 10 years earlier.
1 year earlier the dorsum had suddenly swelled and bruised, but she let it pass without much thought.
CC
2 weeks earlier the same thing happened again, after which the dorsum felt heavy and uncomfortable.
Feeling anxious, she wanted the silicone implant removed but the tip cartilage graft left in place.
OP
The silicone, capsule, and hematoma were removed through an incision inside the nose.
The dorsum, which had been swollen and bluish, settled naturally after removal.
Because the silicone had been displaced to the left, an aesthetic improvement can be seen after its removal.
