Will Dorsal Implant Shift Down Due to Gravity?

My current bridge Implant is silicon. It is oversized.I d like to revise it to a smaller one. However I got different solutions by docs.One doctor told me the existing pocket will be too large for the new implant, it will shift down. He recommended gortex or self rib. Second doctor said new silicon will nOt shift down. It depends on surgeon s skill. he recommended silicon for dorsal implant to avoid warping of rib cartilage and self rib cartilage is only used to construct nasal tip.any views?

Doctor Answers 6

Dorsal implant should not shift down

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Downsizing a silicone nasal dorsal implant is certainly possible.  It is done by removing the old implant and either shaving down the existing implant or inserting a new smaller implant.  The pocket and skin envelop will shrink wrap around the smaller implant without any problems.  It does not shift down with gravity.  Rib grafts do tend to warp over time and they are quite hard in the nose once they have been placed.

Nasal implant

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If you are happy with everything but the size why not have the original surgeon just shave it down to size. If it is not infected, malpositioned or extruding why would you need to remove it? Another option is medpor. It is not just the technique it is the surgeon that counts. You could have 2 different surgeons employing different techniques in cases such as yours and end up with very similar looking results.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Will Dorsal Implant Shift Down Due to Gravity?

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 IMHO the silastic dorsal implants are far superior to rib or irradiated cartilage grafts that have been shown to dissolve unevenly over time creating nasal deformities.  The silicone dorsal graft can be downsized and even though the pocket is too large ...it always is when performing any Rhinoplasty that lifts all the tissues off the underlying nasal structure.  There is no possible pocket larger than that.  Nasal dorsal implants should always be secured with a permanent suture in the supratip area with the upper edge of the implant placed below the periosteum.  This secures both ends of the implant.  Hope this helps.

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Nasal Augmentation in Asian Rhinoplasty

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Hi, Revision rhinoplasty with another silicone implant will depend on the doctor's experience with silicone implants. The implant should be put in through an open procedure and sutured in place so it doesn't move. Remeber any implant whether gortex or rib will move or warp if the surgeon doesnt have experience with nasal augemtnation. See video and link below. Best, Dr.S. 

Revising Nasal Dorsum Implant

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Dear Pumpkin,


Depending on the skills of the surgeon that your results will come to be.

Nonetheless, if the autologous cartilage graft is carved well then the warping is very minimal.

They key is to choose a surgeon of ample experience in that field.

Please do keep in mind that the nose changes with time as one ages with or without surgery.


The best of luck to you and thank you for your inquiry.

Dr. Sajjadian

Will New Silicone Bridge Implant Shift?

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One of the risks of any silicone bridge implant is that it can shift later in life. That is the reason why for the last 35 years I have used the patient's own cartilage or fascia to augment the bridge because this tissue will become incorporated into the patient's own surrounding tissue. I use cartilage from the ear, septum, or diced cartilage from the ribs.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 40 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.