What Options do I Have When Removing a Nose Implant?

Question

I am planning on undergoing a revision this summer that involves removing my first implant, which is silicone, amongst other things. I know that silicone is easiest to remove of the implants, but as you might know with this implant a shine appears from it, which for me is at the bridge, and I was wondering if the shine will go away once the implant is removed and also will my skin sag from having it in for two years? For my revision, I don't plan on another implant.

Andrew Pichler, MD · Answer

Silicone implants can extrude/thin the skin and cause problems. It is a wise choice to have it removed. Whether you need another implant, preferably your own tissue, such as nasal cartilage, is something you'll need to discuss with your surgeon. Sometimes after implant removal there remains enough scar tissue that some dorsal augmentation is still evident.

William Portuese, MD · Answer

It is rather simple to go in and remove a nasal implant; the shininess of the skin often goes away after the implant is removed. The shine of the skin is usually related to the stretching of skin and the light bouncing off of stretched skin. If it is a silicone implant, the implant itself could be removed under a simple local anesthesia as an outpatient procedure.

David V. Martini, MD · Answer

going back a century many implants have been tried including gold, wax, paraffin, silicone gore-tex , the list goes on.  

	natural implants of bone or cartilage are also available.   i prefer this type of implant as your body with integrate over time, which results in a durable implant with a low extrusion rate

	consider this option when discussing with your surgeon

Kimberly Lee, MD · Answer

This is a very common request from patients who have had Asian Rhinoplasty surgery in Asia with a silicone implant.  I prefer to use cartilage from within your own body to avoid the complications that I have seen, some of which are far worse than what you describe. 

	Your skin may have stretched for the duration the implant has been present and you may need to place some of your own cartilage in that space or filler; however, it is hard to say without having properly evaluated you.  The shine you describe can be caused by a couple of different things related to the implant.

	I would recommend that you have a consultation with a board certified specialist in the face who performs Asian Rhinoplasty who can best help you achieve the results you desire.

Francis R. Palmer, III, MD (retired) · Answer

I have used straight, silicone, dorsal implants for Rhinoplasty and Revision Rhinoplasty for over 22 years and IMHO, it's unlikely that you'll be able to go without some type of dorsal implant if you remove the existing silicone implant during revision Rhinoplasty.  It's a bit complicated but during placement of a dorsal implant, the mid section, of the nose where the bone and cartilage meet, often needs to be reduced along with the nasal bones in order to accommodate the thickness of the dorsal implant.  The thicker, the implant, the more this is liekly to be required.  This alows the proper aesthetic size, height and shape of the nasal dorsum to be created.

	  Now, if the skin is too thin or the implant is too thick to accommodate the implant, you may see the sheen of which you speak.  Further, if the existing dorsal implant is removed and the nasal bones have been reduced, you will need some type of dorsal implant to provide closure of the open roof deformity as well as provide the proper aesthetic dorsal height.  IMO, this would mean replacing the existing silicone implant with one that's not quite as thick.  Ear cartilage, rib cartilage/bone have a tendency to dissolve unevenly over time and as such are not appropraitely reliable and stable, IMO, for use a s a dorsal implant.

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Hi,

In some recent large studies of Asian rhinoplasty, silicone was shown to be a very effective nasal implant. In your case, if you are removing it, I assume that you don't like it or have a problem with it. If you don't replace the implant, you will probably have some sort of cosmetic deformity in the nasal dorsum. I would suggest making sure your surgeon can replace the implant with an appropriate substitute.

Best,

Dr.S.

Richard W. Fleming, MD (retired) · Answer

You are smart to remove the silicone implant in the near future. The "shine" that you describe may be secondary to pressure from the implant which has caused the skin to become thin and finally result in extrusion of the implant. If you want or need augmentation of your bridge I have used the patient's own cartilage for 35 years when doing Asian rhinoplasties. Because this graft becomes integrated into the surrounding normal tissue movement or extrusion of the cartilage as well as infection are very rare.

What Options do I Have When Removing a Nose Implant?

Answers (7)

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