Can you cut/reshape an existing silicone nose implant?

Question

I got an Asian rhinoplasty with a silicone I-shaped implant 3 yrs ago. Recently I started seeing a bump at the tip so I asked my dr if it was extruding. He doesn’t think it’s extruding but says the tip is showing more due to recent hormonal changes (switching birth control). He offered to do a revision where he would cut the implant tip to hide it better. Is this actually a safe and realistic option? What are potential complications?

Ajaya Kashyap, MD · Answer

Thank-you for your query. Palpable or prominent implants after augmentation rhinoplasty using silicone  implants is not an uncommon problem. There is often a need to remove the implant if it is more than a minor issue. However, if your implant is in good position otherwise, trimming the implant and covering it with soft tissue may be an option as your surgeon is recommending. I do not put silicone implants, but have had the occasion to trim some stable  implants during revision rhinoplasties, being done for other issues. I have also had to remove several silicone implants because of implant related  problems, and replace them with cartilage grafts. It would be best to discuss different options with your surgeon who can share with you his experience and approach. All the best!

David M. Kowalczyk, MD, MBA, FACS · Answer

Hi there! Great question. Silicone implants can work for Asian rhinoplasty dorsal augmentation. But, if it appears that the tip skin is thinning and the implant may be extruding, it's best to remove it. If the implant ends up extruding, this can create a source of infection and potential future problems with skin loss. I would advise against trimming the implant and replace it with your own cartilage (i.e. from your rib). This gives the best chance to keep your nasal field clean and free from infection. Hope this helps!

William Portuese, MD · Answer

In our practice, we do not use the L-strut type silicone nasal implant for this very reason. The bend at the L strut tends to put too much pressure on the tissues in the nose, and then the nasal skin can break down an then the implant become infected. It's probably best to out cut off the Short limb of the L shaped implant, and just insert the dorsal wafer as long as it is the appropriate size and shape. Alternatively, you you could insert a Flowers nasal dorsal implant manufactured by Implantech.

Can you cut/reshape an existing silicone nose implant?

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