Should I remove L shape Nasal Implant and do a rib graft for my nose?

Question

I am of East Asian descent and 31 years old. I had 1 rhinoplasty in January 2019 where the surgeon made my nose slightly slimmer by breaking the bone and also implanted an L shape nasal implant. While I am pleased with the outcome, I am actually starting to feel very worried about implant extrusion, thinning of nasal skin (in particular the nasal tip) and infection. The surgeon said my nasal bridge is weak. What are the chances my nose will look ok?

Donald B. Yoo, MD, FACS · Answer

Tissue from your own body (autologous grafts) will give you a safer, more permanent result than synthetic implants. While en bloc cartilage grafts, especially from the rib, can warp over time, there are ways to eliminate this problem.  Especially for dorsal augmentation (building up the bridge) using cartilage that is finely diced and wrapped in fascia taken from your scalp can be made into a custom size and shape for your particular nose (DCF). By dicing the cartilage the problem of warping is eliminated, and since it is tissue from your own body, it quickly becomes incorporated into your nose within 2-3 weeks. Results are certainly surgeon dependent, so it's important to do your research in finding an Asian rhinoplasty specialist. @drdonyoo @asianrhinoplasty

William Lao, MD · Answer

It is a relatively older technique and concept to use implant at the nasal tip (ie. L shaped implant) for the problems that you mentioned regarding thinning out nasal tip and having implant extruding in the long run. How it will eventually be really depends on how thick your nasal skin is and also if the surgeon had placed some protective layers on top like on lay ear cartilages etc. But most rhinoplasty surgeon nowadays do not like any implant materials at the nasal tip.

Jacob Tower, MD · Answer

Hello, hope you are well. The chances that your nose 'will look okay' are good. But, of all the alloplastic implants, L-shaped silicone implants tend to be a riskier option with higher infection and extrusion rates (with infection being more common). If infection does occur (swelling, redness, pain, discharge), it usually requires removal of the implant. Likewise, if the skin of the tip of the nose is appearing red or thinning, it usually is a signal of impending implant extrusion that would necessitate removal. If you survey the studies that look at how often these events happen, the consensus would be somewhere greater than 1%, but less than 10%. The corresponding revision rates have been reported around 5-10% for implants like this. It's impossible to predict what will happen in the future, but if you are happy with how your nose appears and have no problematic symptoms, it's safe to do nothing unless any of the concerning symptoms I mentioned arise.
Best,Dr. Tower

Ronald J. Edelson, MD · Answer

L shaped implants gave all kinds of problems compared to a simple straight implant. The new thing is diced rib cartilage to augment the bridge

Should I remove L shape Nasal Implant and do a rib graft for my nose?

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Answer: Rhinoplasty

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Should I remove L shape Nasal Implant and do a rib graft for my nose?

Answers (4)

Answer: Rhinoplasty

Answer: Rhinoplasty

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Everything you need to know about Asian Rhinoplasty

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