L-shaped Vs I-shaped Nose Implants (photo)

Hi Vivian,

Sorry that you are unhappy with your nose following your rhinoplasty. An L-shaped implant adds structure to both the dorsum (top or profile) and to the columella (the base or bottom between the nostrils). An I-shaped implant adds structure only to the nasal dorsum.

If you are displeased with your nose, then a revision rhinoplasty would help. You can have the L removed and replaced with the I-shaped implant. The implant size is also important to insure that the skin is not too tight around it.

You should discuss your concerns with your rhinoplasty surgeon.

Good luck and be well.

Dr. P

The concerns you mention can sometimes arise after use of a nasal implant, and that's part of the reason I'm not a big fan. An L-shaped implant gives the tip definition by placing a fair bit of pressure over a small area of skin to tent the skin out. It cannot reproduce or retain the natural shape of your tip. As a result, it can look a little too pointy and unnatural.

Sometimes, this pressure on the skin can become too much for the skin to bear. If you are noticing redness at your tip, you should see your surgeon or another rhinoplasty expert early to determine the cause. If the skin is under too much tension, this would be a good reason to intervene early with a revision procedure to avoid injury to the skin.

The other problem with an L-shaped implant is the possibility that it will twist or move over time and cause your nasal contour to appear crooked. These problems are less likely with an I-shaped implant that stops just above your tip because the forces of healing and skin contraction do not act on it in the same way. An I-shaped implant really justs rests on your bridge without providing the same type of structural support that an L-shaped implant is intended to give. Still, an I-shaped implant can look bulky, blocky, and unnatural.

Our preference for ethnic augmentation rhinoplasty is to use your own cartilage for augmentation. If you are happy with your natural tip, you should be able to keep that roundness. Augmentation of your bridge can be done by itself to balance with your tip and other features. Assuming the redness is not the start of a problem, you may want to wait a little longer for things to settle. If you continue to be unsatisfied, rest assured that you can achieve a refined but natural nose.

I personally don't like foreign material in the nose. It sounds like the implant is causing too much pressure and bulk in the tip of your nose. If this is true, it could eventually erode thru the skin of the tip of the nose. I have seen many patients like this. My preference is for your own cartilage from the septum to build up the bridge, though silicone I implants can be used. The disadvantage of the I implant is possible infection which can occur with silicone. See a revision rhinoplasty specialist to guide you in making the best choice for you.

Hi,

L shaped nasal implants do not work well in ethnic rhinoplasty. They are meant to elevate the bridge and refine the tip but instead make the tip look bulbous or too stretched. The pressure on the tip can cause pressure necrosis and extrude. The also cause pollybeak deformities. The best implant to get is a custom carved silicone implant. This type of implant elevates the bridge and naso-frontal angle and is specific to your nose. Each nose is different therefore each implant must be different. See link below for further information about the custom carved Slupimplant TM.

Best,

Dr.S.

The L-shaped silicone implants placed in the Asian noses have had a moderate amount of failures. They tend to place too much tension on the underlying skin and cartilaginous framework. This causes a breakdown in tissue and chronic inflammation, with resultant infection, and then the implant may have to be removed. Smaller Silastic implants such as the Flowers nasal dorsal implant in a small or medium size work very well to build up the bridge on a non-Caucasian nose.