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!
Immediate Revision for Severely Crooked and Shifted Nasal Implant?
Doctor Answers (5)
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.
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 implant. As your surgery was one year ago, your implant can be revised at any time. Utmost attention to detail in the alignment and level of placement of any implant is paramount.
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
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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.
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 justify to an insurance company. That's between you, your doctor and them.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.