Nasal Implant Removal After Asian Rhinoplasty?

You can have your implant removed as soon as you are sure that swelling has subsided enough for an accurate diagnosis of your issues.  Usually this can be anywhere between 6-12 months after surgery.  Silicone implants in general form a significant capsule around the implant, and it may be advantageous to remove the implant closer to the 6 month mark to avoid mature scar contracture.  When having a revision, make sure that you visit a surgeon who has experience in revision rhinoplasty and especially Asian implant-related rhinoplasty.  Rhinoplasty is a tremendous passion of mine and I would be happy to provide you a comprehensive evaluation.  Good luck!

 

An implant could be removed and switched for a smaller one.  Generally, this would not cause any problems.  The skin should not be stretched out from your larger implant.  The irregularity could be arising from other issues such as infection or improper implant placement.  L-shaped implants are more prone to these type of problems and most experienced asian rhinoplasty surgeons no longer use this type of implant.  Another choice would be to remove the implant entirely, or replace it with a graft from your own body

Thank you for the questions. It seems like your implant may be infected or is pushing too much on the skin (extruding). It can be removed in a relatively straightforward procedure. Then, after the nose has been allowed to heal, a revision surgery can be performed. The bridge of the nose can be built up with cartilage from the septum, ear, or rib.

Removing Nasal Implants are probably medically indicated especially in light of your history and that the "pimple" you may describe may indicate an infected implant area and or impending pressure necrosis of the skin.  The prior operative note would be very important for your surgeon to review prior to this procedure.

Hello,

Yes, if you are having second thoughts about your silicone implant, it is reasonable to go ahead and remove it.  With a little assistance the "extra" skin will more than likely settle down and flatten out to the correct contour.  While it is probable that the implant is putting pressure on the tip, it is also possible that the cartilage grafts in the tip are malpositioned making them easier to feel.  Either way revising your nose is possible.  Additionally, if the skin doesn't completely settle down, injectible filler can be used to expand what little extra skin there may be creating a smooth appearance to the dorsum of the nose.  Make sure you thoroughly discuss your surgical plan before going back in.  Revision rhinoplasty is never easy.

Good luck,

Dr. Shah

The type of implant you had placed along the bridge will determine whether there will be an issue with its removal. If the implant extends to the tip of the nose (a variation of the L implant, or and extended I implant), then it may affect the tip of the nose. If the implant was simply placed on the tip only recently, it may be safe to remove it altogether. However, if significant alteration of the tip cartilage was performed, then the tip may need further work after removal of the implant.

I’d generally recommend waiting at least nine months to a year before making any changes following nasal surgery. Close communication and follow-up with your surgeon along the way is important.

In the case of Medpor implants, they are notoriously difficult to remove much later down the road because of extensive tissue in-growth which, incidentally, is helpful in fixing the implants in position.

The implant can be removed but the second operation better get things right. There is a "law" of diminishing returns with any operation. You might end up with a scarred up and irreparable nose if you submit to too many operations. I would interview several surgeons who do a lot of secondary rhinoplasties and choose the one you trust the most to get a good result with only one more operation.

Generally, removing a silicone nasal implant is better done sooner rather than later.
Implants which are kept in for a prolonged period may cause a prolonged tissue reaction which can create additional scarring. Attempting to "save" an implant with antibiotics doesn't tend to work either and usually delays the inevitable: removal of the implant.
Think about the reverse process with a causcasian rhinoplasty. People have large humps all their lives and when the hump is removed, it does not usually cause a sagging nose.
If you do not desire the implant, have it removed sooner rather than later.
I hope this helps!

Generally speaking a nasal implant can be removed. Silicone implants have the least amount of ingrowth from the surrounding tissues and are the easiest implants to remove. Gore-tex and med-por are much more difficult implant to remove due to the tissue in growth. Redness in the nose after an implant can be the sign of an infection. Once the skin of the nose has been violated with an implant, the damage is permanent. Prior to a rhinoplasty procedure, a well planned operative plan with both the patient and surgeon on the same page should be performed. Computer imaging, if done in a reasonable manner, can help facilitate communication and help determine whether or not augmentation to your nasal bridge is aesthetically desirable.