Reconstructing nose after nasal silicone implant removal?

In my experience of more than 35 years of revision rhinoplasty I have never used rib cartilage for reconstruction as I can get enough cartilage from the ears etc. to rebuild the nose. I would never place any cartilage whether rib or ear in a nose that is currently infected. Have the silicone implant removed and wait at least 6 month before having anything done.otherwise you were taking too much risk of having the cartilage become infected.

When I was at Johns Hopkins we used to say there's no right way to do a wrong thing. Nasal implant to been all too common in the past and they all too often lead to this complication the problem is how do you deal with it if it were an infected breast implant we would all recommended to come out the pocket be sterilized and free of infection for six months before we would put an implant back in cartilage because it Kamprath this some infection might be an option but you're still at risk of it getting infected and the unfortunate thing is you would have to have a second rib done which anyone will tell you after I regret is a painful ordeal.without seeing you and knowing your case as well as knowing what implanted in there I doubt that anyone can give you a definitive answer I do recommend you see an experienced surgeon one done a lot of a rhinoplasty's and possibly has a great deal of experience with your breath before you proceed with surgery and often times anabiotic temporize the situation until a reasonable plan can be made.  

Dear SarahIn general, placing a rib graft in an infected surgical field is an invitation for more complications. Keep in mind that harvest of the rib is an additional procedure and if you loose the graft, you have undergone all that surgery with no gain. Nasal tip cartilage grafts (ear cartilage) do not usually need to be removed at the time of your surgery.In my experience, I would remove your silicone implant. Then schedule your rib graft 3 or more months after that. It is true that you can sometimes "get away"  with a single stage procedure but most surgeons prefer not to take chances with their patients. You can have the same look safely a few months later. The swelling from the infection and the capsule from the implant will likely hold your dorsum in a well augmented position for a while!Follow closely with your surgeon and take the time to ask all your questions and understand all the relevant issues.

It is very common to remove infected implants and replace the volume with rib cartilage.  Using autologous tissue such as this will reduce the likelihood that it would also become infected.  The cartilage that was placed in the initial surgery may be removed, cleaned and replaced as necessary - although a rib harvest should supply more than enough new cartilage.  I recommend seeking out a Board-Certified Plastic Surgeon who will accurately examine your nose and formulate a plan tailored to your needs and wishes.  Good luck!

You are receiving good advice from other surgeons on this page. In the face of a cultured infection remove the silicone. It will be your surgeon's decision perhaps with the consultation of an infectious disease specialist as to how long before re-operation. Diced cartilage in temporal is fascia would be the preferred method for many experienced rhinoplasty surgeons for reconstruction due to its relatively low complication rate. If the old tip cartilage graft appears involved in the infectious process remove it or it will protract the healing process.  This is a good opportunity to get a nose that will be 100% you

If the implant is infected it needs to be removed and then wait several months before considering secondary surgery. Autologous (your own) tissue (cartilage) is best and most reliable. The tip cartilage if looks OK needs not be disturbed.

I would not replace cartilage at the same time as removal of the implant.  If your tip graft is inplace and well vascularized, I would leave it alone. Recovery time means different things.  Initial reduction of swelling will take 1-2 weeks.  Final results with take 9-12 months.  I would not place a secondary cartilage graft for atleast 6 months