Can my Crooked Nasal Implant Be Fixed?

Nasal implants, commonly silicone, can move and are thus aesthetically not pleasing when displaced. A recommendation to correct the implant placement is a good choice. surgery90210

There is an outside chance that you can salvage the implant currently in place. It might be that you simply need to adjust the positioning of the implant. This also depends on what type of implant is currently in the nose.

There is a good chance, however, that you need to take the implant out and essentially start over it terms of the nasal reshaping process. If that is the case, you will likely be better off not using a foreign material to reconstruct the nose. This would be a good opportunity to replace the implant with cartilage, which is better tolerated when performing rhinoplasty and revision rhinoplasty.

When you notice that your once straight implant is changing, a thorough evaluation becomes necessary. Scar that forms around an implant naturally can start to warp the implant. The implant may be in a pocket that is too big so it starts to move around. The implant may be changing the shape of underlying structures that give way and cause the implant to move. The overlying skin is thinning asymmetrically. The implant was not shaved symmetrically. Whatever the reason, there is typically a solution that a plastic surgeon or facial plastic surgeon specializing in revision rhinoplasty can provide for you. In general the implant is removed and examined for defects. The pocket is made straight, and if necessary, reduced in size. The implant is then replaced and stabilized.

Nasal implants that are asymmetric can be revised. Typically the asymmetry is due to one (or more) of these problems:

The implant is too long for the nose and is bent due to lack of space
There is deviation of the septum which makes the bridge crooked and thus the implant is crooked
The pocket for the implant was not made in the midline or it was made too large causing the implant to shift

Typically there are 3 options for revision:

Remove, revise and reinsert the original implant
Remove and replace with a new implant
Remove and replace with cartilage from the patient, typically from the rib.

When an implant is not placed under the periosteum or if it not placed in the midline or if the pocket that it sits in is too tight, then the implant can move and become crooked.  This is a very easy problem to fix and can be done in literally a 15 minute surgical procedure. 

There are many reasons for an implant to look crooked but there are definitely ways to help. A thorough evaluation by an experienced rhinoplasty surgeon would be necessary and it would be helpful but not absolutely necessary to have your old operative records. This would help the surgeon to determine what material was used and what the best course of action is to correct the problem. At times, the implant may need to be removed and replaced while at other times minor revisions can be used to camoflauge the appearance of a deviation.

Yes, as long as the implant is the appropriate size and intact, it can be corrected.  First the implant is typically removed, the pocket made straight, and then the implant reinserted into the anatomical pocket through a closed incision.

Unlike many other more general questions, your question is best answered after a thorough evaluation.
In general, foreign implants in the nose are not a good idea and we rarely ever use them. However, experience has shown that silicone or other prosthetic implants can and are used in certain ethnic patients with varyingly good results.
In your particular situation, we would have to evaluate why the prosthetic is crooked, is it mobile, and is the overlying skin doing well? Occasionally we have noted that the dermis can thin over time when the implant is mobile. After examining you, we would know if the prosthetic is something we would retain and revise or if we should remove the prosthetic in its entirety and use your own cartilage in order to revise the previous surgery.
A proper assessment of your particular circumstances is needed to provide any further help.

A crooked implant can almost always be repaired. But on occasion it may require complete removal of the implant and then replacement in a new position after healing has occurred.