I Have a Silicone L Strut in Place and Have Found the Tip is Going Grey. Implant Needs to Be Removed!

I had a primary rhinoplasty and felt that that too much bone was removed from the bridge. So a silicone L strut was put in place later. The implant has been in place for 6 years, however in the last two years I have noticed the tip is going grey and the collamellur is drooping. The implant has to be removed and the nose left to heal before they will consider any grafting. Will I be left with a deformed nose underneath and is there anyway that they could graft it when they remove the implant?

Doctor Answers 6

Nasal Implant Needing to be Removed

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There is no doubt that the silicone implant needs to be removed from the L Strut of your nose. However, you will be left with some deformality after the procedure. Without further history, I wouldn't know if you can be grafted at the same time.

Silicone implant

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First, it certainly sounds like the implant needs to be removed. Second, it is advised that any additional surgery happens in one month before scar contraction and you are not able to augment the nose. Commonly, with unfortunate patients like yourself, I remove the implant, treat with antibiotics for two weeks and then place a graft of your own cartilage and fascia. In doing so, you will have augmentation of your nose with a biologic filler from your own body that will last a lifetime.


Be healthy and be well,

James M. Ridgway, MD

I Have a Silicone L Strut in Place and Have Found the Tip is Going Grey. Implant Needs to Be Removed!

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 The L-section of the silastric nasal implant should be removed immediately before it erodes through the nasal skin.  This can be done as aprt of a closed Rhinoplasty but time is not on your side.  Hope this helps.

If you have an implant in your nose and the skin is turning grey, the implant needs to be removed

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The general teaching is to remove the implant and let the area heal over a number of months. The problem with that is you can get scar contracture and a small nose with scar tissue. I have actually put banked cartilage grafts into such noses with good results and avoiding the months of anxiety over having a nose that is too small

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 134 reviews

Removing a silicone nasal implant and replacing it at the same time.

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Removing a silicone nasal implant and replacing it at the same time is what I typically have done for 35 years. I see no need to wait since the time of removal is the best time to do the reconstruction with you own tissue. I typically use septal and ear cartilage and almost never use rib which is far more painful and leaves a scar.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Implant eroding through skin

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L-shaped silastic implants are known to come out through the skin ("extrude") over time in some patients.

It does need to be removed before it puts a hole in your skin.

I think you are going to get a number of different opinions as there is no clear answer, but I prefer getting the implant out and letting the nose settle down for at least 6 months before rebuilding it, using either cartilage if available, or Gortex sheeting.

Douglas J. Kibblewhite, MD
Vancouver Facial Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.