L-Shaped implant causing too much pressure on nose tip. Should I wait or try to do revision ASAP?

Signs of impending implant extrusion include increasing redness and tenderness.  Extrusion is a gradual process, as the skin is slowly thinned by the implant to the point of ulcerating.  In this case, when the skin is being thinned by a synthetic implant, the risks of waiting too long may be greater than operating sooner than the "recommended" time.  Using tissue from your own body (autologous grafts) will greatly reduce the risk of this possible complication.  

While it is early it sounds like the nasal tip is deviating to the right. After 5 months there might be a slight amount of numbness and sensitivity of the nose but I rarely get pressure as a complaint. I would have it evaluated by a revision rhinoplasty surgeon who specializes in Asian rhinoplasty. There are a few surgeons in the LA area. Even if he or she doesn't operate just yet you can have the evaluation and get the correction process started. 

Nasal tip pressure after silicone implant. I would revise it now since continued pressure will thin the skin and can go thru the skin. See an experienced revision rhinoplasty surgeon. 

This is one of those times where I think getting seen sooner rather than later is a good idea.  If that implant has pressure on the skin of the tip of the nose, it may cause some serious problems.  I recommend getting in to your surgeon for a visit now.

Silicone implants are extremely common is Asia and generally do not cause problems in the Asian population or other people with thick soft tissue. However, there are several issues associated with their use and because I perform so many revision rhinoplasties I frequently see patients that have complications arising from them. Constant pressure from a foreign material on the skin can result in extrusion of the implant (yes, it comes right out through the skin; usually at the tip). Sometimes these implants can be seen through the skin (particularly in darker lighting) because they are translucent. Because they are synthetic there is no true integration with the tissue and hence they tend to be mobile. Because they have no blood vessels coursing through them there is a chance for infection to develop at any time. For all of the above reasons I do not use foreign materials of any kind if at all possible but instead I use their own tissues. While the operation is more complicated the results look more natural and are much safer. I usually employ cartilage harvested from the chest wall but sometimes I use septum, ear and temporalis fascia. I have even used bone when needed.As for the specifics of your case I would advise having consultations now and seeing what the surgeons say. My own feeling is that there is no reason to wait in such cases; as your problems will not improve over time and might actually become worse.

Normally one waits for revisions but it sounds like you are having a collocation and therefore would recommend being seen nowDr Corbin

While most revision procedures are recommended at a one year period you fall under a different category due to the pressure from the silicone implant. It is usually recommended to remove the implant immediately if you are having pressure issues to preserve the integrity of the skin and avoid any protrusion of the implant through the tissue. I would see your surgeon or seek a second opinion sooner rather then later. Best regards, Michael V. Elam, M.D.

After examination I will probably recommend removal of  the L-shaped silicone implant - prolonged pressure can cause the implant to extrude through the skin creating a scar that will be difficult to correct. If circulation is not compromised and most of the post-op swelling has resolved we can discuss alternative techniques for revision probably using your own cartilage.