Immediate Revision for Severely Crooked and Shifted Nasal Implant?

asked 2 years ago by smilebaby123 in San Francisco, CA
Latest answer by Richard W. Fleming, MD
Question viewed 570 times
Tags: nose, revision

I got a nasal implant done by a doctor a year ago and it has shifted to one side. It's the L-shaped silicone kind. I often would even feel painful and pressurized in that area.And there is the constant feeling of something in my nose and its blocking my breathing. Can a doctor reposition the implant, add a new implant in or use cartilage immediately? He KNEW the implant was too long during surgery and didn't bother shaving down the bump on the other side of my nose. Can insurance cover this since it isn't only cosmetic? thanks!

5 answers to Immediate Revision for Severely Crooked and Shifted Nasal Implant?

Silicone Nasal Implants

One of the problems with silicone implants is they can shift as you have seen. This is why I prefer to use the patient's own cartilage for augmentation. It is not an emergency, but have the revision in the near future. The pain you're experiencing may be due to excessive pressure on the overlying tissue; this can lead to skin breakdown and exposure of the implant. You can have the silicone repositioned or removed and replaced with cartilage.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon

Crooked nasal implants can be fixed

In my experience, after treating patients who have seen me after having silastic implants from other doctors, I find silastic to create a dense scar capsule that may become asymmetric and which can veer an implant to one side. In the nose, this is less than desirable and therefore silastic is not my preferred nasal implant. In one surgery, your implant can be removed and replaced with your own cartilage (rib or septum are my most preferred), Goretex, Medpor, or combinations of cartilage and... more

Thomas T. Le, MD
Baltimore Facial Plastic Surgeon

Nasal implants

Silicone implants are easy to shift. Rib cartillage graft is much superior to silastic implants and can be shaped and customized to your needs. Remove the silastic implant with an open rhinoplasty and use rib cartillage graft, if smaller implants are needed then a septal cartillage or ear cartillage can be used

Samir Shureih, MD
Baltimore Plastic Surgeon

Silastic Implants

Hi, Silastic implants should be replaced immediately if they are severely shifted. All silastic implants should be custom carved and placed in a precise pocket to prevent shifting. The typical silastic implants bought from an implant supplier will have a tendency for slide under the skin if they are not placed correctly. Since the surgery was initially cosmetic, insurance does not typically pay for revisions. Best, Dr. S.

Oleh Slupchynskyj, MD
New York Facial Plastic Surgeon

Nasal implants can be revised

L shaped implants, or any nasal implant for that matter can shift. Yes, they can be removed and revised or another implant used at the same time. Silicone is not my first choice but can work well for some patients. Other options are your own cartilage (nose, ear or rib), Gortex and Medpor. Regarding the insurance issue, that is a sticky point. Some companies won't cover if the original surgery was strictly cosmetic, others may consider something. However, a shifted implant is difficult to... more

Steven J. Pearlman, MD
New York Facial Plastic Surgeon

www.mdface.com

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