Protrusions Inside the Nose at the Columella or Roof After Augmentation Rhinoplasty (Columellar Protrusion, Nasal Implant Extrusion)

After augmentation rhinoplasty in which silicone is placed on the dorsum and ear cartilage or septal cartilage in the tip to add height,

quite a few patients come to us because something protruding can be seen or felt inside the nose, at the columella or the roof of the nostril.

They come worried that the silicone may have pushed through inside the nose,

but in most cases the tip cartilage has been pressed by the silicone, buckled, and protruded,

or a columellar strut placed between the columellar cartilages

has pushed the tip cartilage sideways or buckled it so that it protrudes.

In such cases this can be corrected even with a closed approach:

suturing the buckled portions of the tip cartilages together can straighten them.

Before Surgery

Something protrudes from the roof inside the nose as if it had sunk down.

Immediately After Surgery

The silicone extending from the dorsum to the tip and the ear cartilage resting on the tip were removed, and the buckled tip cartilages were 

sutured together, which straightened the protruding cartilage; the surgery was performed through an incision inside the nose (closed approach).

These are views immediately before and immediately after surgery.

Through an incision inside the nose, the sunken roof of the tip was lifted and flattened.

Left

Protrusions are visible inside both sides of the nose. The tip cartilages have been pressed and buckled by the silicone.

Right

This shows the correction achieved by silicone removal and tip cartilage repositioning (suturing). 

Before removal, the silicone on the dorsum can be seen showing through the skin.

The crooked tip and columella became straight after the removal surgery.

The straight dorsal line, in which the outline of the silicone had been visible, changed to a softer appearance.

The height of the dorsum did not decrease much after removal, and it looks more natural.