While L-shape implants have a greater risk of extrusion through the skin in the tip of the nose, I-shape implants still carry a higher risk of extrusion through the skin in the bridge of the nose than autologous grafts (your own cartilage). Cartilage has an infinitely lower chance of extrusion than synthetic grafts (practically none under normal conditions), and a much lower risk of infection or migration. Overall, autologous grafts are a much more permanent and safer option for reshaping the nose during Asian rhinoplasty.
Your question is a very good one. In the short-run the L-shaped nasal implant is easy to place, well tolerated and can quickly give the desired effect. Unfortunately, there can be rather serious issues over time. These include infection, permanent skin changes and discoloration over the nose and actual erosion of the implant through the skin. One cannot predict who this will happen to unfortunately. I would suggest the use of your own cartilage for grafting purposes to help avoid the issues with silicone implants and their complications.
There is a risk of extrusion with any silicone implant, but this is more of a problem with the L Shaped implants. This is why I have used cartilage grafts to augment Asian noses over the past 35 years.
We do not recommend L-shaped strut silicone implants placed in the nose due to the problems we have seen with them. For Asian rhinoplasty, we will use a Flowers nasal dorsal Silastic implants manufactured by Implantech. Any synthetic implant can protrude if the implant itself was too big for the skin envelope. It's rare to ever see a cartilage graft extrude. For many of examples of rhinoplasty, please see the link below
Hello chai and thank you for the question. In short, yes silicone implants can extrude and cause a lot of problems. For the most part Asian rhinoplasty involves building the bridge up to give better definition. A variety of implants have been used for this purpose. I personally do not use such implants in my practice as I have seen numerous disasters relating to their infection and subsequent extrusion, thus requiring me to remove them and treat the "so-called" aftermath. This can occur many months after the original surgery and for the most part these patients were operated on in Asian countries (especially South Korea). Many surgeons like working with such implants because they are quick to place and provide good results in select patients. I personally will only use native cartilage or other tissue to build up the dorsum. The silicone implants tend to form a capsule and become mobile in the nose as they never truly get integrated into the tissues as grafts from your own nose or rib would. Hopefully this information helps.