Deviated Columella and Nostrils and Chronic Inflammation After Silicone and Ear Cartilage Rhinoplasty, Corrected by Simple Removal Alone

After augmentation rhinoplasty, we often see the silicone implant shift to one side

and even the nasal tip and columella become deviated.

The usual solution is to make an open approach and place a columellar strut to stand the columella upright.

In some cases, however, this can be corrected with closed-approach removal and simple repositioning of the tip cartilages alone.

 When, as here, the deviation of the nasal tip and columella is not severe and the tip cartilage has been pressed obliquely by silicone shifted to one side,

so that the tip is deviated, a closed approach is made, the silicone implant and the cartilage graft placed on the tip are removed,

and the displaced tip cartilages are repositioned to the center, allowing a straight and natural correction. 

PH

A young woman who remembered only that she had surgery with silicone and ear cartilage 10 years ago

CC

Once or twice a year, the dorsum felt tight with a foreign body sensation,

and the cartilage grafted to the nasal tip shows through the skin, revealing its outline.

The nasal tip is shifted to the left, and the nostrils and columella are tilted and asymmetric.

P/E

The dorsum is wide and thick, and the glabella is high, giving a straight dorsal line, 

and the nasal tip and columella are tilted to the left.

Left photo

The dorsal line is straight and the glabella is too high,

giving a strong, artificial impression

Right photo

The removed "L"-shaped silicone implant and capsule,

and the ear cartilage that had been placed on the nasal tip

The dorsum, thick and crooked before surgery, became straight and slim after surgery.

The nasal tip that had shifted to the left and the cartilage graft showing through above it are gone, and the tip is natural and straight.

The tilted columella, nostrils, and nasal tip have all become straight.

The absence of a surgical mark on the columella after surgery shows that a closed approach was used.

The dorsal line, which had looked long and straight with an overly high glabella,

has become natural and soft.

After removal, the nasal tip has come down slightly and the dorsal line can be seen to look natural.