Visible Nose Implant After Rhinopalsty

Question

Each day, I believe I can see the implant at the tip of my nose and when I smile, the implant is even more obvious. My tip feels like it is extremely stretched to the point that no blood is running through giving it that almost clear pale skin color.

	My question is what should I do about this? All I really wanted was for him to fill in the gaps caused from a bump on the right upper side of my nose to even it out. In my situation, would a second surgery cost more? Thank you.

Toby Mayer, MD · Answer

You should ask your surgeon first what he would do and secondly how much it will cost. From what you have said and the photo it appears that the skin overlying the implant is too tight. I would the see an experienced revision rhinoplasty surgeon to have a second opinion BEFORE having another surgery. The first surgeon may do the surgery for little or no cost while another surgeon will charge you. But you don't want to have a third sugery!

Otto Joseph Placik, MD · Answer

Discuss these concerns with your surgeon. There are many details which are not clear. 
Is this a foreign body (silicone, medpor, gortex, etc), or is it a cartilage graft, or is it an injectable agent? These all have an impact on the choice of how to manage your concerns.
Excessive blanching (whitened appearance to the skin) may be indicative of decreased blood supply to the area. This can in turn result in secondary problems.

William Portuese, MD · Answer

If the skin has been stretched out over an implant in the nose and it is visible and palpable, it is probably time to have the implant removed and replaced back into a normal anatomical position so that it does not stretch the skin. If the skin stretching continues, it will wear down the skin, get infected and have to be removed completely. Implants should not be felt or not make the skin very pale in color. If blood cannot get to the skin, it will break and the implant could potentially push through the skin.

Peyman Solieman, MD · Answer

Dear Vi,
I do not want to be an alarmist but based upon what you are saying and the picture, we would recommend you see a rhinoplasty specialist in the near future. Sometimes implants are too big, especially in thinner skinned patients. Over time this can cause the overlying skin to break down and die. The result is a much more difficult problem to correct. So please see your surgeon or another surgeon soon to at least check
We all understand that cost is important but those costs can become substantially more and the time and effort to reconstruct far more cumbersome if you have skin break down.
We genuinely hope this helps and if we can be of further help to you please let us know.

Visible Nose Implant After Rhinopalsty

Answers (4)