[Revision Rhinoplasty Case Study] L-Shaped Silicone Implant, Contracted Nose, Upturned Nose, Closed Approach, Tip Cartilage Repositioning

Side effects in the nose caused by silicone implants are all too common. 

The problem is that they do not ease with time but gradually get worse.

Commonly seen side effects include chronic inflammation, thinning of the skin, implant show-through,

contracture, an upturned tip, and tip deformity.

The most desirable course, therefore, is not to use a silicone implant in nasal surgery,

but if one has been used and side effects like those above appear, the silicone implant is removed

and the nose either returns to its original appearance or, at the time of removal, is revised using autologous tissue and

human donor tissue in revision surgery.

Today's case is one in which side effects had developed from a silicone implant,

the implant was removed through a closed approach together with simple tip cartilage repositioning,

and a natural nasal shape was restored. 

PH

20 years ago: silicone implant (closed approach)

15 years ago: Gore-Tex, donor costal cartilage (closed approach) => traffic accident

10 years ago:  silicone implant, ear cartilage, osteotomy (closed approach)

CC

Visible silicone implant outline,  thinned skin, upturned tip

P/E

Removal of the L-shaped silicone implant, capsule, and ear cartilage at the tip + simple tip cartilage repositioning (closed approach)

The silicone implant sat too high, making the nose look long and showing at the glabella. 

The silicone implant was slanted and crooked.At the tip, the skin had thinned because of the implant, and the implant showed through.

After surgery, all of this can be seen to look natural.

Because the silicone implant was crooked, the tip cartilages were also tilted and the nostrils asymmetric.

After removal, simple repositioning alone brought the columella back to the midline, and the tip became symmetric.

The silicone implant on the dorsum was too wide and the bridge looked long, giving a masculine appearance.

After removal surgery, the bridge looks natural.

The silicone implant had ridden upward, making the glabella too high.

After removal surgery, the dorsal line looks natural.

The dorsal line, which looked masculine because of the long nose and high glabella, became feminine and natural.

The tip, which had been pointed and upturned, became soft and natural.