Revision Rhinoplasty Clinic: Septal Perforation + Nasal Silicone (Implant) Removal Case
Literally a perforation of the septum,
appearing as if a hole had been punched through,
"septal perforation"
brings not only aesthetic dissatisfaction
but also functional discomfort,
so many patients, seeking a way to improve their symptoms,
come to our clinic.
Today,
as a revision rhinoplasty case,
one in which a silicone implant & septal perforation were resolved
over 2 stages of surgery
will be presented.
PH:
1st surgery: silicone implant 6 years ago
2nd surgery: 8 months ago, silicone implant on the dorsum + septal extension graft
CC:
Starting a week ago, the silicone implant began protruding into the nasal cavity,
and a septal perforation also developed.
OP:
Because of the infection caused by the implant extrusion,
removal surgery was scheduled first, as stage 1.
- Removal of the silicone implant, capsule, infected tissue, and onlay
- SEG kept in place to maintain nasal length (stage 2 surgery planned later)
The preoperative photos of the left and right nasal cavities
show a septal perforation about 10 mm in diameter,
and the patient complained of a whistling sound inside the nose
with every breath.
After the stage 1 removal surgery,
the bridge, which had stood unnaturally high,
returned naturally to its original state,
and the infection has cleared.
The silicone implant that had protruded into the nasal cavity
can also be seen to be completely gone.
P/E:
The dorsum and glabella became lower,
and there are no longer any signs of infection.
OP:
Removal of the septal SEG
Septoplasty (swing door)
L-strut with costal cartilage + closing the perforation with a piece of costal cartilage wrapped in perichondrium + augmentation rhinoplasty with MegaDerm
For the desired nasal line
and to improve the functional discomfort,
a stage 2 surgery was planned.
This is the nasal cavity before the stage 2 surgery;
the septal perforation, about 10 mm in diameter,
remains unchanged.
The harvested costal cartilage and perichondrium:
a 12 mm piece of costal cartilage is prepared
and wrapped in perichondrium to close the perforation.
The bridge, which had been broad and crooked, is now straight,
and the bridge and tip are higher and more refined.
The tilted columella can be seen to sit straight.
The bridge, which had been sunken, also
stands naturally without looking artificial,
the bridge line is well defined and the nose is longer,
giving a more masculine impression.
On checking the septal perforation as well,
the perforation was completely resolved,
and the bothersome whistling
sound also improved.