2 years post op and the skin at my nose tip is thinning - will this lead to an extrusion? (photo)

Question

I had a rhinoplasty procedure done for more than 2 years now. I had a silicone implant with an ear cartilage for the tip. I have noticed this for a year now, I just wanna know if this is a skin thinning on the tip area of my nose that will eventually possibly result to an extrusion. Thank you in advance for your answers.

Man Koon Suh, MD · Answer

The nose tip appears to be getting thinner, with a noticeable protrusion, possibly indicating a problem with the silicone implant. If left unaddressed, there's a significant risk of the skin at the nose tip tearing and the silicone implant becoming exposed. It is advisable to promptly remove the implant and undergo corrective surgery.

Donald B. Yoo, MD, FACS · Answer

Hi Reserved908112,

Based on your photo, the implant is putting pressure against your infratip and has thinned it enough to have some visible contour irregularity. Typically extrusion will be preceded by redness or an acute trauma to the area. Your skin is not yet red, and you didn't mention any tenderness, so barring trauma in the area you are not at immediate risk, but you are correct in having concern for the future potential of extrusion. At some point you should consider removing the implant and leaving the nose in its natural state, or using your own tissue to reshape the nose in a safe and permanent fashion.

Jacob Tower, MD · Answer

Hello, hope you are well. Your photo shows either a portion of the implant or the cartilage graft showing under the skin. (It's not easy to judge from this photo alone, and not being able to see and feel the area directly). If it's the implant, it may be impending extrusion. In any case, this will not get better on its own. I would highly recommend seeing your rhinoplasty surgeon or another surgeon with the appropriate qualifications who can advise on options for possible revision versus monitoring. It would be better to proactively address the issue rather than potentially suffering skin breakdown on the tip of your nose to take action.
Best,Dr. Tower

Michael S. Kluska, DO · Answer

Nasal silicone implants, are often fraught with complications, including extrusion due to the mobility of the nose. To counter this, you could get micro pellet fat grafting around the implant and nasal tip to soften and cushion the area where the silicone implant is. Additionally, hyaluronic acid fillers, may be an alternative choice to improve thickness and camouflage to the nasal tip.

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

Hello! I would definitely keep an eye on it. It appears to be thinning as you have shown. If you're near your doctor, you may want to contact him or her to see if anything needs to be done. Hyperbaric oxygen may be an option if blood supply looks compromised.

2 years post op and the skin at my nose tip is thinning - will this lead to an extrusion? (photo)

Answers (5)

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