Pros and Cons of Removing Exisiting Implant from Nose

Question

Hello. I'm a 26 years old male of Asian descedant. I had my first rhinosplasty surgery 6 years ago to refine the tip of my nose and narrowing of the nostrils to create a more caucasian aesthetics. I'm interested in taking out the exisiting implant (not sure what type of implant but I'm finding out today) and wanted to know what is the pros & cons for doing this. Can I go without an implant? Will a plastic surgeon achieve balance and symmetry after the implant is removed permanently?

Sam Naficy, MD, FACS · Answer

How different your nose will look with the implant removed depends on the size of the implant - replacing the implant with rib graft is your best long-term option.

Thomas A. Lamperti, MD · Answer

Your nasal implant can be removed. You don't necessarily have to have anything put in it's place but there may be issues with skin redraping and possible irregularities. A lot of the result would be based on how you heal.

	You could also replace the implant with a rib graft that could be custom carved for your nose. Discuss your reasons for wanting to remove the original implant with your surgeon. This would help guide the best course of action to take.

Otto Joseph Placik, MD · Answer

Certainly the method to achive balance and retain the projectio would be to replace the implant with a cartilage graft most likely taken from the rib.

Richard H. Tholen, MD, FACS · Answer

Removal of your existing implant (regardless of its composition) will almost certainly NOT give you back your pre-operative appearance; your nose would likely look substantially flatter, and may heal with scar irregularities that can be disfiguring. From your photos, you look good from the front, though there are visible irregularities from below in the medial columellar area and nostril rims. This could be due to displacement of the lower end of your implant, or distortion of the medial crus of your own alar cartilage by the end of your implant.

	It is evident that revision rhinoplasty is a reasonable consideration, but I would suggest consultation with several revision rhinoplasty experts to determine what exact course of action is best for you. In this case, less may in fact yield a better final result than more surgical intervention! I would probably recommend leaving your implant in and try to improve the cloumella and nostril area. Best wishes!

A. John Vartanian, MD, MS · Answer

Dear LandonLosAngeles,

	Here are the pros and cons of removing a long-existing nasal implant such as yours:

	Pros:

	
		Peace of mind that you no longer have a foreign object in your nose
	
		Reduced chance of an unpredictable implant infection (imagine developing an infected implant while on vacation...)
	
		Maybe returning your nose to its original and more natural form (if that's what you want).


	Cons:

	
		You may lose the cosmetic benefits that the implant is providing now
	
		The hassle and cost of undergoing an implant removal procedure (which  BTW is pretty minor and can be done under local anesthesia in most cases).


	So, the decision is yours.  I have removed a good number of nasal implants.  In the Caucasian nose, the implants are less tolerated that in Asian noses.  Nevertheless, if you are in doubt, I would tend favor removal.  An office exam can also let your surgeon know if the implant is causing other problems (like nasal obstruction).  All the best, Dr. John Vartanian

Travis T. Tollefson, MD, MPH · Answer

Dear Landon Los Angeles,  If your implant is symmetric and without swelling or other problems,

	before removing the implant,  you should strongly consider the potential problems such as:

	
		scar contracture
	
		need for further surgery
	
		and need for harvesting cartilage from some other site such as septum, rib, or ear. 


	Best Wishes

Joseph Campanelli, MD · Answer

This is a complicated problem.  The place to start is with the existing appearance.  What are you unhappy with?  Why do you want the implant removed?  Is it causing problems?  What are you trying to obtain that is different than what you have now?  Make sure you have thought about these issues because they are very important in helping your surgeon define the best course for you.

	The type of implant will make a big difference in determining the ease of a revision surgery.  Silicone is very easy to remove, medpor much more difficult.  Once removed, your nose will take on the characteristics that it had before and you will need to decide whether you want to keep this appearance, if not then you will need another implant.

Peter A. Aldea, MD · Answer

Regarding: "Pros and Cons of Removing Exisiting Implant from Nose
	Hello. I'm a 26 years old male of Asian descedant. I had my first rhinosplasty surgery 6 years ago to refine the tip of my nose and narrowing of the nostrils to create a more caucasian aesthetics. I'm interested in taking out the exisiting implant (not sure what type of implant but I'm finding out today) and wanted to know what is the pros & cons for doing this. Can I go without an implant? Will a plastic surgeon achieve balance and symmetry after the implant is removed permanently?"

	A nose implant is usually used to build up the back / dorsum of the nose in people with a deficiency in this area (Asians, Africans, Mestizo noses (Central America) etc) and give it a refined narrow appearance from the frontal view. Without an implant here, the back of the nose would probably revert to its pre-implant appearance more or less.

	The problem I see involves your tip. You appear to have a round, ball like tip with separation of the feet of the lower lateral cartilages (the lower portion of the right cartilage is deviated into your nostril). You also appear to have a healed visible scar along the rim of your left nostril extending to the right. This is NOT a classic incision. Was this an attempt to THIN your nostrils? This may have implications as regards the blood supply of the tip and overall results of all subsequent nose surgery. Proceed with caution.

	Dr. Peter Aldea

Richard W. Fleming, MD (retired) · Answer

The answer will vary depending on your goals. If the implant is removed your nose will not look like it did before your original surgery, even if you have revision work done at that time. If you like your present appearance, augmentation with your own cartilage will be necessary after implant removal.

Pros and Cons of Removing Exisiting Implant from Nose

Answers (9)

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