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3rd Surgery for Nose Implant, What to Do?

asked 1 year ago by missynl in netherlands
Latest answer by Shepherd G. Pryor, MD
Question viewed 248 times
Tags: nose tip, facial implant, multiple, options, risk

In 2009 i had my first surgery. They've placed a nose implant but afterwards you could clearly see the tip. It was to large so in 2010 I had a second surgery where they've shorten the implant but now you can see the tip again. I've spoken to them and they've given me some options: remove everything, shorten it and use some fat as filler for the tip, or use some body material (ear) instead of the implant. What would you recommend and what are the risks?

8 answers to 3rd Surgery for Nose Implant, What to Do?

Removing Nasal Implants

In our experience, nasal implants are prone to movement that may cause problems over time, especially at the tip where a hard edge of the implant may show through the skin. For that reason, we prefer augmenting the nose with cartilage. From the photos you show, your profile looks pretty good aside from the area of concern at the tip. One option would be to cut back the implant to just lay over the bridge alone and do a tip revision using your own cartilage. Septal cartilage would be best for... more

Jason Litner, MD
Beverly Hills Facial Plastic Surgeon

Removing nasal implants

In my experience, if you would like to avoid a 4th surgery I would remove the implant and reconstruct with your own material, namely rib cartilage. This would give you the most predictable control and very small chance of further problems. On top of that, it would be very reasonable to place a fascia onlay graft to the tip and dorsum after the rib cartilage is placed to soften contour and prevent there being any issues moving forward.

Shepherd G. Pryor, MD
Scottsdale Facial Plastic Surgeon

www.valleyfacialplasticsurgery.com

Removing nasal bridge implant

Given your history and photos I would recommend removing the implant and augmenting the area with your our tissue. Usual this would mean septal, ear or rib cartilage. You seem to require quite a bit of cartilage in which case rib may be the best way to go. In the long run I find that autogenous grafts provide a safer, more durable result with no risk of rejection (since they're your own tissue). Using careful carving techniques I've not found an issue with graft warping. more

Thomas A Lamperti, MD
Seattle Facial Plastic Surgeon

www.drlamperti.com

Revision options for implant

Based on your photos it appears that you had a low bridge and most likely will require removal of the implant and use of a rib cartilage graft - ideally your own

Sam Naficy, MD
Seattle Facial Plastic Surgeon

seattleface.com

Revision rhinoplasty requiring grafts to replace a visible implant

From the pictures, it appears that you originally had quite a low nasal bridge, a condition we call saddling. Such a large dip in the nose requires a lot of cartilage. If you still have cartilage left in your septum, there should be enough to replace your now visible implant. If not, a rib graft may be necessary so that the bridge looks uniform. The problem with ear cartilage is that it is difficult to make it appear straight since most ear cartilage is curved and over time irregularities... more

Russell W. H. Kridel, MD
Houston Facial Plastic Surgeon

www.todaysface.com

Nasal implant

You will always have these problems as long as you have synthetic implants in your tip. You need to have the tip redone with your own cartilage. Implants on the dorsum alone are better tolerated but still risky.

Michael L. Schwartz, MD
West Palm Beach Plastic Surgeon

www.palmbeachface.com