Asian rhinoplasty using ultra soft silicone, complications in the future? (Photos)

Question

I want to get rhinoplasty done in south Korea using ultra soft silicone for bridge augmentation and cartilage for tiplasty. I am worried about complications with synthetic implants (infection, extrusion) in the future. I don't want to use autologous grafts for bridge augmentation as I know they can be absorbed leaving an irregular appearance. I only want to do rhino once, but will not mind having revision every decade or so. Will removing the implant later cause irreversible damage?

Alejandro Nogueira, MD · Answer

Alloplastic materials do provide lack of stability overtime, extrude, dislocate, get infected and ALL sooner than later have to be removed with minor or major associated complications and deformities; only the autologous grafting... if the right ones we are talking about... are stable and permanent.The right method to raise dorsums in any patient, a must in almost 
all asian rhinoplasties, is using cartilage, which stays there for a 
lifetime if no complications happen during the first months; as summary:
-fascia wrapped diced cartilage is a mess of a technique, unstable, 
unpredictable contour irregularities, unnatural touch, late resorptions,
 infections, pseudocysts, etc... it is trendy these years because is 
waaay easier the good and safe alternatives, thus making widely 
accessible to any limited skills surgeons the goal of raising a dorsum

-alloplastic (silicone or goretex, matrix, etc) are even worse, some 
almost a mess or destructive (like solid alloplastis implants)
-fillers I will not even comment, a catastrophe

-the right option for a sunken dorsum is cartilage grafting onlay 
piece (ear or thin slice of rib), with (thin skinned dorsums) or without
 (thick dermis dorsums) temporal fascia camouflage blanket graft 
underneath the skin of dorsumFor your understanding, a basic reduction rhinoplasty of any race is 
about 1 hour surgical time, or less in master's hands. Obviously they 
are the cheapest.
A medium complexity rhinoplasty is 2-3 hours, in case it requires some grafting, of any race. Price a bit increased.
A high complexity one is about 3-4 hours, requiring multiple 
grafting, like arab, latino, jewish ones for example. Can be considered 
expensive.
And very high complexity ethnic noses, which are asian and black 
(afroamerican and afrocaribbean), take 5-7 hours and are a real 
technical challenge accessible to few talented surgeons. They are quite 
expensive.
Mention apart for the out-of-rank filipino rhinoplasties, the hell 
for rhinoplasty surgeons; I tell you by own experience as multi-race 
nose surgeon, I've tried them all.
Asian rhinoplasties may cost twice than a basic reduction nose job. Alternative? doing a quick hackjob.
May anyone tell you an asian rhinoplasty costs the same than a 
regular case... is like someone telling you a heart transplantation 
should not differ from pacemaker insertion... run away the fastest you 
can, you might be talking with Dr. Nick Riviera!
If you research asian rhinoplasty cases online you'll find somethin 
awesome: 99% of the before and after cases look just slightly different 
if not literally the same; this may answer your question.
Additionally, if you explore my Q&A list or in general in the 
whole RS you'll find a majority of asian rhinoplasty patients 
complaining of poor and non sufficient change, or maybe got shortcuts 
like prosthesis and other rubbish inside the nose.
Final note: inversely... if someone somewhere says a basic reduction rhinoplasty will cost the same than an afroamerican or asian... could be due to the poor quality of the ethnic cases... or, why not... they are adding and abusive overprice to the basic rhinoplasty cases. You must pay for what you get, and you have to get what you deserve / need technically, just it, fair play.
I strongly recommend you find a real expert in asian rhinoplasties, save the 
money and travel wherever required. 
Please do post or send privately a full set of good quality, well lit
 and focused standard photos: frontal, both lateral views and both 
oblique views, also from underneath the nostrils.
Feel free to request any additional information from me.

Emmanuel Mallol Cotes, MD · Answer

Thank you very much for sharing your concerns with us.The harmony between facial parts makes us instinctively recognize the beauty... without knowing it, without defining it, just a perception that surprises and captivates us.In this regard, I suggest perform a Closed Rhinoplasty (without visible scars) to treat the tip, base and nasal bridge.With this procedure you get a delicate nose, better harmonize with your other facial features.Respectfully,Dr. Emmanuel Mallol Cotes.-

Donald B. Yoo, MD, FACS · Answer

I feel very strongly that synthetic materials should be not be placed in your nose during Asian rhinoplasty. Personally, the best way to achieve permanent results in the safest manner is by undergoing Asian rhinoplasty with autologous grafts - tissue from your own body.  Grafts from your own tissue will have a much lower rate of complications than synthetic implants such as silicone, Gore-tex or Medpore.The best way to determine what specific changes will look good on your face, and what changes are surgically possible, is to do your research to find the top Asian rhinoplasty specialists and consult with several of them in person.  During your consultation, your photos can be computer-morphed to show how the changes to your nose will affect your appearance.  An Asian rhinoplasty specialist will have the experience to determine whether the morphed images are surgically attainable.

Charles S. Lee, MD, FACS · Answer

If you are worried about implant problems in the future but you also do not want to use your own tissues, the only option you have is to correct the tip area using your own tissues and leave the bridge alone. I don't agree that autogenous tissues give many problems, but there's always some risk to any procedure you have done. Good luck!

Somyos Kunachak, MD - Account Suspended · Answer

Hi Yasminn.s,

Silicone implant had been long used for Asian Rhinoplasty (more than 5 decades actually), and so far the incidence of complications such as extrusion, is very rare. However, if it really bothers you, the other option is to use silicone for the bridge, then septal cartilage for the tip as septal cartilage has very low chance or resorption (almost 0 chance).

Regarding the use of different types of silicone for the bridge, it really doesn't matter, what matters is the expertise of the surgeon who will perform the procedure.

Asian rhinoplasty using ultra soft silicone, complications in the future? (Photos)

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