Should I Go for L Shape Silicone Rhinoplasty?

I prefer to use the patients own cartillage either from their septum or ear.In the long run I feel its safer and gives an excellent esthetic results. Many implant materials and shapes are used throughout the world with much success so discuss your options with your surgeon to be re-assured. The attached video explains how septal cartilage grafts can be used.

Using silicone implants, and especially L-shaped implants, is not a great choice for Asian rhinoplasty because of the high rate of complications associated with them.  For the safest, longest lasting result, I recommend using grafts constructed from your own tissue.  

The L shape silicone graft carries unnecessary risk with it (migration, extrusion, infection).  While it will provide excellent aesthetics in the short term it does not become incorporated into the nose and it is not a permanent option due to the risk of extrusion (thinning skin and becoming exposed).  Autologous grafts (tissue from your own body) is a safer, permanent option.  

This is strictly my opinion, as each surgeon has an opinion about synthetic implants.

For me, I switched to using only the patient's own tissues for reshaping the nose and have had a great improvement in the results. Synthetic implants can create problems at any point in time, even years into the future. L shaped implants in particular can cause undue stress at the nasal tip and should be avoided in my opinion.

Cartilage is best for Asian rhinoplasty in my opinion. In 35 years I have not had any infection using cartilage but have seen many silicone implants come thru the skin or get infected.

L shape silicone implants have been traditionally used for augmentation rhinoplasty in Asians with variable success rates due to variables such as surgeon's experience, patient's skin, amount of augmentation, etc.  More contemporary rhinoplasty technique which I use in my practice with more predictable results in Asian patients is to use a silastic implant to augment the bridge of the nose and use natural cartilage and to shape the nose tip.  This technique minimizes complications with L shaped implants such as implant extrusion.

L-shaped silicone implants were very commonly used many years ago but are rarely used now because of risk of infection, extrusion and tip deformity. There are many excellent alternative choices for the tip surgery including your own cartilages and thus there is no need to use L-shaped implants.

 

We do not recommend L-shaped silicone implants due to the complications that we have seen over the last 25 years from them.  We do use a Flowers nasal dorsal silastic implant to the nasal bridge to simply raise the height of the bridge or will use the patient’s own cartilage as well.  Creating definition in the tip of an Asian nose can be very difficult to do, but there are a few things that can give it moderate change and definition that can be accomplished during the rhinoplasty procedure.

Building up a higher bridge and a more defined tip is a very common request from Asian patients.  My preference is always to achieve a natural looking nose that fits the rest of your face.  I find that the silicone implants look quite unnatural.  I've also seen many unhappy patients who want revision surgery after having implants placed from another surgeon or in Asia because of the appearance or from a complication (infection, extrusion, migration of the implant).  I prefer to use cartilage from your own body to build the bridge along with narrowing the tip at the same time. Please consult with a board certified specialist in Asian Rhinoplasty who can assist you in achieving the results you seek.

Silicone nasal implants can be helpful to augment the nose, but this is not the only method to accomplish augmentation. Silicone (and other synthetic materials) can have an increased risk of infection and extrusion compared to using cartilage. The cartilage can come from your rib, ear, or septum or can even come from a package (radiated cadaver cartilage). Each technique has advantages and disadvantages. You should discuss this further during your rhinoplasty consultation.