Revision rhinoplasty due to silicone infection. What to do? (Photo)

Question

I flew over to Seoul just because my silicone nasal implant kept getting infected. I visited my surgeon here and he thinks I can control it with Gentamicin shots on my nose. I got this shot twice and it already feels much better and swelling has gone down. Other doctors here are saying it will not subside and I should re do the surgery with Gor-Tex, my own tissue between my gluteus , and cadaver cartilage. I don't know what to do??

Alejandro Nogueira, MD · Answer

I must express my most sever disagreement with the opinions you have received and the treatments applied on your nose from the very fist moment.Synthetic or alloplastic prosthesis should NEVER ever be used in rhinoplasties, it is a sign of poor technical skilss, laziness and lack of honesty; it is a well known fact these implants end in bad or catastrophic complications, poor resulds, needing rebuild with own tissues or even with irreparaible lifetime stigmas sooner or later; do google their complications or search here in RS for them, you'll find what I am talking about.Dorsal grafting to raise the dorsum, a routine, golden standard and absoluterly required maneuver in asian rhinoplasty cases is and has to be done with OWN tissues, and with prioritarily with ear cartilage grafting, alternatively and second in order rib cartilage grafting, and eventually a temporal fascia onlay / concealing graft to hide their visibility (nevertheless this is seldom necessary in asians due to their thick dorsal skin). Period. All the alternatives, exotic, freak, weird and very "imaginative" you've been provided only show the deepest lack of knowledge, reliability and technical resources.Regarding your current situation, that prosthesis is doomed, condemned, insalvable; like any other prosthesis used in surgery (breast implants, knee prosthesis, etc) when they get infected they can not be saved by antibiotics, much less injected topically (reckless decision, indeed, if any is prescribed has to be fundamentally oral or parenteral), the prostheses infected have to be removed asap to prevent extrusion, skin damage, deep structures destruction (in your case nasal bones and cartilages, which are higly threatened by a adjacend chronic infectious source) and allow the earliest reinsertion or, in your case, replacement by natural stuff.The topic antibiotic injections received are a non-standar treatment and have no chances to terminate the infection, the prosthesis has to be removed; actually there are solid reasons to remove it even without the infectious episode, however if infected another natural material dorsal graft CAN NOT be inserted at this stage; a coold down period to allow infection to disappear and tissues recover is necessary to permit an optimal take (vascular integration) of the newly inserted own tissues.My advice: to seek immediate removal of the prosthesis, any surgeon with basic skills my perform it. At a later stage do seek the services of a surgeon who gathers BOTH features: top-notch revision rhinoplasty experience and vast ethnic rhinoplasty (asian, afroamerican, etc) experience, with a whit of mastery (your tip could be shaped better, honestly).Feel free to request additional information from me.

Arian Mowlavi, MD, FACS (license on probation) · Answer

Rib grafting (whether you owns or a cadaver) is the safest, most effective means of curing your problem. The Gortex graft is only gong to inevitably get infected as well.

David Alessi, MD - Account Suspended · Answer

It is unlikely that it will go away.  Gent injections and other modalities can get it to calm down temporarily.  I will need to be removed.  The process is removal then let it settle down for 6 months. Reconstruction can be done anytime after the waiting period.  Your own tissue is the best choice (rib or ear cartilage or fascia).  Best wishes.

Revision rhinoplasty due to silicone infection. What to do? (Photo)

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Revision rhinoplasty due to silicone infection. What to do? (Photo)

Answers (3)

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Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.