I had revision rhinoplasty 13 years ago where a silicone implant was used to build up my bridge. The implant has now extruded into my right nostril and I am also being treated for infection. I was told by the surgeon that he used thinnest implant approx.1-1.5 mill. If so, is it possible to remove implant and balance out tip. I still have a bulbous tip with polly beak. Why wasn't this done before if implant is SO thin? I had two closed procedures would open help with tip? Thank you.
Can Failing Silicone Implant Be Removed and Tip of Nose Balanced Out?
Doctor Answers (5)
Nasal tip can be balanced 6 months after infected implant is removed
If the implant has extruded into the nostril and is infected it must be removed. No other procedure should be done to the nose during an infection. The implant can be removed in the office. Reconstruction can be performed 6 months to a year down the road once all the infection is cleared and swelling has subsided. An open or closed procedure would not matter when the appropriate time comes to reconstruct the tip.
Pollybeak and Silicone Implants
If silicone implants are not placed correctly in the nose they can cause pollybeak deformities, bulbous tips, move around and extrude. The fact that your implant is extruding through your nostril is evidence that it probably wasn't put in right the first time. I believe that all silicone implants should be put in through an open rhinoplasty approach to achieve a proper surgical plane and secure the implant with a suture. I think the implant can also be place in a better position through an open approach. Your implant should be removed and treated like an infected implant. Revising your nose, after the infection has cleared, with a silicone implant is ok with an experienced nasal implant surgeon.
Extruding Silicone nasal IMplant
When a nasal silicone implant breaks through either the skin or the nasal lining it must be removed. Having a prolonged infection is potentially dangerous and can destroy nasal tissues. It should be removed as soon as possible, and the infection treated with antibiotics and topical ointments. After the area is clean, reconstruction with a cartilage graft is the best option. With one failed synthetic implant, the risk of using another is too high.
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If you have infection of the nasal bridge implant then the implant needs to be removed first, then treat the infection very aggressively. Let it heal completely. Six months later you can have revision rhinoplasty.
This is one of the prime reasons why I don't like using implants for the nose. You would need the infection to be cleared up before any further surgery. From what you describe, an open approach would be the best approach to address the issues you describe. The most important factor is finding a surgeon who is skilled at reconstructing your nose. Please consult with a board certified specialist who can assist you in achieving the results you seek.
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.