[Garnet Plastic Surgery Dr. Baek In-soo’s Plastic Surgery Column] What to Do When a Nasal Silicone Implant Protrudes

Garnet Plastic Surgery Dr. Baek In-soo’s

Doctor's Note #19

Hello. I am Dr. Baek In-soo, a board-certified plastic surgeon at Garnet Plastic Surgery.

Today, I would like to introduce a case involving gradual contracture after rhinoplasty.

A woman in her 20s who visited our clinic had previously undergone rhinoplasty with silicone.

There were no particular problems immediately after the surgery, but over time she felt that her nose was gradually being pulled upward,

and the skin at the tip of her nose became red.

At first, she did not think much of it, but as the skin at the nasal tip continued to be irritated,

it would swell up like a pimple, and the symptom of the nose being pulled upward became severe, so she came to our clinic.

Preoperative analysis

From the front, the nose was pulled upward so the nostrils were very visible, and because the dorsal implant was floating, the nose appeared crooked.

From the side and at a 45-degree angle, the nose was also lifted, and the shape of the nasal tip had changed due to the silicone being on the verge of protruding.

In the photo taken from below, the skin at the tip of the nose had become red because it had been heavily irritated by the silicone.

The CT scan showed that the silicone implant had descended significantly, which had made the skin very thin,

and it was a situation in which the implant was just about to protrude through the skin.

Surgical method

The silicone implant was removed, the scar tissue in the nose was separated to lower the lifted nasal tip,

and the harvested rib cartilage was used to lengthen the nasal tip; for the bridge, autologous rib cartilage was used instead of silicone.

Because the skin at the nasal tip was extremely thin, when harvesting the rib cartilage, the fascia and perichondrium around the rib cartilage were also harvested

to firmly reinforce the thinned skin at the tip of the nose.

Postoperative course

From the front, the lifted appearance of the nose improved significantly, and the crooked bridge was corrected as well.

From the side and at a 45-degree angle, the lifted-looking nasal tip came down considerably, and the height, length, and shape of the nose were all achieved using autologous cartilage.

The redness of the nasal tip skin, which had been irritated by the silicone implant, also returned to its original state.

Conclusion

Today, we looked at a revision rhinoplasty case of a patient whose silicone implant was on the verge of protruding.

The most important part of contracture nose surgery is lowering the shortened nose,

but properly reinforcing the skin at the nasal tip, which had been irritated by the silicone, is also a very important part.

When reconstructing a contracture nose, even without using silicone implants,

it is possible to achieve a look and feel comparable to that of an artificial implant,

and I hope you will also keep in mind that it is possible to create a beautiful nose shape as desired.

Thank you.