How far is nasal reconstruction possible after foreign material removal?

Cases of visiting the hospital because of illegal implants often come as time passes,

and the nose gradually becomes lower and more rough in shape, so many people visit

the hospital because they want to change the appearance. There are also two broad

cases: people who notice something abnormal in the nose because it becomes red or

is accompanied by pain and then visit the hospital.

Among cases where the nose has become low and rough in shape due to a foreign

material, many people tend to think of surgery as something simple.

They assume that, just like a regular nose surgery, the problem of raising the nose

will be solved and visit thinking about a simple method.

However, if such cases are approached with a standard nose surgery method,

there is a possibility that problems may arise later, so it must be understood

that it is very difficult to approach them in the same way as a regular nose surgery

using implants.

In such cases, the foreign material is first removed, and then the removed space is

filled with the patient’s own tissue, or surgery is performed to graft cartilage.

Ironically, however, most people who visit the hospital with dissatisfaction about

their appearance feel that they have no problem at all, so they do not want the

foreign material that is causing the problem to be removed and often continue on

without concern until they begin to feel something abnormal in the nose, which is

why it is often difficult to resolve.

People who visit because of problems caused by foreign material often say they are

worried that the area where the foreign material was inserted has become red,

keeps hurting, or the swelling rises and falls every day, causing the nose shape to

change little by little.

They cannot talk to other people about their nose, try to relieve the symptoms with

standard medication treatment at another hospital, and eventually decide on surgery

and come in because of persistent problems.

In such cases as well, surgery is performed to remove as much of the problematic

foreign material as possible and replace it with the patient’s own tissue.

When patients visit because of such problems, surgery is usually not done all at

once; instead, it is performed in stages over about 2 to 3 operations.

Because the area where the foreign material was inserted and the surrounding area

have scar tissue and inflammation caused by the foreign material gathered together,

if the problematic parts are removed during the first surgery, normal tissue may also

have to be removed. Therefore, during the first surgery, the foreign material is

removed while preserving the surrounding scar tissue and inflamed tissue as much as

possible, and then surgery is performed again.

The goal of foreign material removal surgery is to complete the procedure with as

few problems as possible, so it is better to proceed in stages.

After the first surgery, injection treatment and medication treatment to reduce scar

tissue are also carried out.

Usually, after the first surgery, the surrounding tissue is allowed time to settle,

and a second surgery is considered about a year later.

When the second surgery is performed, reconstruction surgery using autologous tissue

is done, and if foreign material removal is insufficient when considering the second

surgery, foreign material removal may be performed again.

When foreign material is removed through revision nose surgery, there are sometimes

questions about reconstruction.

Is reconstruction possible after removal of foreign material from the nose with

autologous tissue rhinoplasty?

Autologous tissue is free from the hard texture of artificial implants,

is relatively safe even when the skin becomes thinner,

and tends to have a lower incidence of inflammation.

It is often more effectively applicable in cases of foreign material removal due to

capsular contracture.

After carefully separating and dissecting the skin and cartilage tissues where

contracture has occurred due to inflammation so that they can stretch sufficiently,

after removing the artificial implant, if the length of the nose is extended without

recurrence or bending using autologous tissue such as septal cartilage, ear cartilage,

or rib cartilage, it is possible to safely complete the procedure while meeting the

patient’s needs.

For cases with a short nose shape, cases requiring surgery due to injury, and cases

where the skin has become severely thin after foreign material removal,

using rib cartilage from the chest, using dermal grafts, or wrapping with the

temporal fascia can also allow revision nose surgery to be completed safely.

Which method is most suitable for revision nose surgery to remove foreign material?

The surgical approach is divided into open and non-open methods depending on the

purpose of removing the nasal foreign material, the current state of the nose, and

the degree of side effects.

Except for cases with severe side effects where all nasal implants and artificial

materials used in the first surgery must be removed, a non-open method is also

possible.

Sometimes people misunderstand that revision cosmetic surgery always requires a

larger incision range than the first surgery, resulting in a longer recovery period

and greater financial burden. However, even in revision nose surgery, various surgical

methods are applied depending on the current condition, so rather than worrying

alone, it is better to consult with a specialist and find the appropriate method.

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