Is it normal that my nose bridge is movable?

Question

I had a rhinoplasty done three months ago, in which silicone was used to raise the bridge and ear cartilage was used to raise the tip. I've noticed the bridge recently has started to "lean" towards the right, and as a result, I could move the bridge slightly from left to right and vice versa. Is this normal? What could cause this issue?

Joseph Mele, MD · Answer

There are two issues: nasal implant location and mobility. Silicone implants are frequently used to build the upper nasal dorsum. They can augment the profile of nose when viewed from the side. These types of implants are smooth, flexible and firm like rubber. They are held in place by a thin wall of scar than forms a pocket around the implant. Since the implant is not attached to the bone, it can be deflected left and right by light pressure. Once released, it should return to its original position. Too much manipulation can lead to a pocket that is too large, and the implant may shift unpredictably.The second issue is the resting position. Sometimes the scar will become tighter on one side and push the implant off the midline. For example, if the the left side of the pocket gets tight, it pushes the implant to the right. Once the pocket is mature, it  is hard to correct malposition with massage, and a revision may be necessary. Often, I will try to use cartilage instead of silicone to avoid this, and other potential complications. For larger augmentations; however, there is often not enough cartilage, and an implant is necessary.

David Gilpin, MD · Answer

Thank you for your question.  No, in general, you should not be able to move the bridge (or dorsum).  I would recommend you see your surgeon for this issue.  They may need to re-splint and/or re-tape this area.  In some instances you may need another (small) procedure to secure the implant.  However, be sure to see your rhinoplasty surgeon about this!  I hope this helps! -David Gilpin

Heather J. Furnas, MD · Answer

A silicone implant can move, since it isn't fixed to bone. The body builds a scar pocket around it so it normally stays in place. However, it's possible for the scar to give way with too much force, and for the implant to be displaced. See your surgeon for an evaluation and an accurate assessment. In the meantime, it would be best not to move the implant around.

Brian J. Reagan, MD · Answer

A silicone prosthesis to augment dorsal height is a higher risk, higher reward type of approach.  It is a more popular approach in Asia than in the United States.  The silicone definitely works well, but it doesn't incorporate into the tissue.  Thus, exact pocket dissection is critical.  I recommend taping the dorsum and definitely don't manipulate the implant.

Frederic H. Corbin, MD (license restricted) · Answer

If your implant was not sutured down but simply placed in the pocket created for it it will move aroundDr Corbin

Richard W. Fleming, MD (retired) · Answer

The movement of your silicone implant is not normal but is one of the complications seen after use of this material. This is why I do not use silicone for nasal augmentation; preferring to augment the nose with the patient's own cartilage.

Is it normal that my nose bridge is movable?

Answers (6)