Hello, I currently have an infected silicone implant for my nasal bridge. I will be getting it removed in 2 days. My PS has indicated that he may be able to replace my implant with a fat graft depending on the severity of infection. My question is 1) is it safe to replace low-grade infected silicone within same operation, 2) pros and cons of fat graft? I would really like to avoid additional revisions in the future. What are the complications of a fat transfer? Is it relatively safe? Thank you.
Answer: Silicone implants in the nose They are disastrous, should never be used, they displace, extrude, get
Helpful 2 people found this helpful
Answer: Silicone implants in the nose They are disastrous, should never be used, they displace, extrude, get
Helpful 2 people found this helpful
March 23, 2015
Answer: Replacing an Infected SIlicone Implant in Revision Rhinoplasty Hi Sarah, thanks for the question. If infected, the safest thing to do may be to remove the implant and wait for the infection to clear before performing a reconstruction. My preference for augmenting the bridge is to use the patient's own cartilage, as it looks and feels more like a natural nose. The first choice is cartilage taken from the septum, inside the nose. If this cartilage has already been removed, ear or rib cartilage may be necessary in revision cases. I'm not sure if you are referring to fat transfer (liposuction from the body and injection in the face) or dermal fat grafting, but in either case, you may be better off going the cartilage route. I've seen patients with dermal fat grafts placed by other surgeons and the nose tends to look soft and doughy rather than refined and natural. Of course, your surgeon may be experienced in the use of fat grafts for the nose, but it's not my preference. The best advice I can give you is to consider additional consultations with revision rhinoplasty specialists before moving forward. Best regards,Dr. Mehta
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March 23, 2015
Answer: Replacing an Infected SIlicone Implant in Revision Rhinoplasty Hi Sarah, thanks for the question. If infected, the safest thing to do may be to remove the implant and wait for the infection to clear before performing a reconstruction. My preference for augmenting the bridge is to use the patient's own cartilage, as it looks and feels more like a natural nose. The first choice is cartilage taken from the septum, inside the nose. If this cartilage has already been removed, ear or rib cartilage may be necessary in revision cases. I'm not sure if you are referring to fat transfer (liposuction from the body and injection in the face) or dermal fat grafting, but in either case, you may be better off going the cartilage route. I've seen patients with dermal fat grafts placed by other surgeons and the nose tends to look soft and doughy rather than refined and natural. Of course, your surgeon may be experienced in the use of fat grafts for the nose, but it's not my preference. The best advice I can give you is to consider additional consultations with revision rhinoplasty specialists before moving forward. Best regards,Dr. Mehta
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March 24, 2015
Answer: Fat transfer to the nose Dear sarah001It is standard practice to replace nasal dorsum with a solid replacement. Autogenous tissue, such as septal, ear or rib cartilage is best, when not available, or due to donor site morbidity, silicone or other synthetic implants work well. In my experience, fat grafting requires soft vascular beds and an infected nasal dorsum is likely to respond very poorly to fat grafting. In all fairness, I have never attempted fat grafting to the nasal dorsum for volume loss because it doesn't make good technical sense to me. Any irregularity would be easily apparent and if you are lucky enough for the graft to take evenly it might look bumpy when you gain or loose weight. A good alternative might be temporalis fascia with or without some cartilage grafts.
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March 24, 2015
Answer: Fat transfer to the nose Dear sarah001It is standard practice to replace nasal dorsum with a solid replacement. Autogenous tissue, such as septal, ear or rib cartilage is best, when not available, or due to donor site morbidity, silicone or other synthetic implants work well. In my experience, fat grafting requires soft vascular beds and an infected nasal dorsum is likely to respond very poorly to fat grafting. In all fairness, I have never attempted fat grafting to the nasal dorsum for volume loss because it doesn't make good technical sense to me. Any irregularity would be easily apparent and if you are lucky enough for the graft to take evenly it might look bumpy when you gain or loose weight. A good alternative might be temporalis fascia with or without some cartilage grafts.
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