Tip Cartilage Repositioning and Nasal Implant Removal: Case #3

The patient in this case said that 17 years earlier, at another clinic,

they had undergone augmentation rhinoplasty with an L-shaped silicone implant.

After many years, however, the patient complained of pressure on the dorsum and headaches,

and the nasal tip had changed to look as if it were being pulled from both sides, so the patient visited our clinic for improvement.

Examination showed that the implant extended from the glabella to the nasal tip,

and the tip cartilage had collapsed under the pressure of the implant.

The skin was also tight rather than soft.

The patient did not want revision surgery and wished to avoid scarring, so “implant removal” and “tip cartilage repositioning” were performed through a closed approach.

During surgery, however, the implant in the nose was found to be Gore-Tex rather than L-shaped silicone.

At the nasal tip, the Gore-Tex was stacked in two layers. 

Along with the implant, the surrounding inflamed tissue and scar tissue were removed, and the compressed, collapsed

 tip cartilage was separated and repositioned to restore its normal form and shape.

The entire procedure was performed through a closed approach, with no additional cartilage grafting.

4 months after tip cartilage repositioning and nasal implant removal

As the tip cartilage that had been compressed by the implant returned to its place,

the nose looks natural, and the once-tight skin has become soft again.

The nasal tip, which had been separated from the implant and collapsed before surgery, has regained its projection.

It is now in balance with the dorsal line, forming a natural profile.

After surgery, the pressure in the nose, the headaches, and other symptoms disappeared,

and the patient was satisfied to have their original nose back.