When Can I Have a Revision Rhinoplasty? (Photo)

last month the doctor took out the silicon because it literally expose already on the tip of my nose want to undergo again for another Rhinoplasty... is it possible?because i also consult my doctor about the revision using my cartilage but he said it is not good because the cartilage of the ear is so thin and can not make higher bridge... what can I do now? I am getting married next month, and because of this, i dont know if i can wear my wedding dress ... i feel so ugly... please help me

Doctor Answers 4

Implant infection after rhinoplasty

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After an infected implant has been removed from the nose, especially when it has extruded, it is important to wait prior to revision to allow the swelling to resolve and scar tissue to soften and mature. Additionally, the infection needs time to completely resolve to prevent reinfection of any cartilage graft material used during the revision rhinoplasty. It is usually best to 12 months prior to revision rhinoplasty. During revision rhinoplasty, cartilage from 1 or both ears or rib may be required depending on what the goals of revision surgery are. Additionally, it appears as though you have an indent on the nasal tip, and this may require some special considerations.

In the interim, you may consider injection of soft tissue filler such as Juvederm or Restylane as a way temporarily improve the appearance of your nose. Soft tissue fillers can be used in certain situations to correct deformities of the nose. One of the more common uses is to fill depressions of the nose especially after surgery.

There are several important considerations when using soft tissue fillers in the nose to improve safety and prevent both short and long term complications. Use temporary fillers NOT permanent (Silicone, Artecol). Use gel fillers NOT particulate (Radiesse, Sculptra). The amount of filler injected at one time must not be excessive as this can cause problems with not only the appearance but also the blood supply. Hyaluronic acid fillers are ideal for injection into the nose as they are temporary (usually last for over 1 year) and gel. Additionally, if too much filler is injected or there are problems with blood flow to the nose, an enzyme (hyaluronidase) can be injected to dissolve the product and reduce the risk of skin loss and scarring. Both Juvederm and Restylane are commonly used hyaluronic acid fillers. Another consideration is that you have had previous surgery which causes the skin to be less pliable, so injecting fillers can be more challenging. In these situations with thin skin and scar tissue, using a hyaluronic acid filler that is softer is better to avoid pressure necrosis and skin loss. Additionally, small volumes should be injected and sometimes this may need to be done over several sessions instead of a large volume in one session.

You would benefit from seeing a board certified plastic surgeon that performs both revision rhinoplasty and soft tissue filler injections into the nose to see what would be an appropriate option for you.

After silicone implant extrusion

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You do need to give your nose time to heal after the extrusion and you will likely need rib cartilage grafting

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Revision Rhinoplasty After Nasal Implant Removal

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Yes, you can have a revision surgery done but only after 9-12 months when your nose has healed up. There are make ups that can be applied to camouflage the scar. After, the healing process is complete, then there are several options such as diced cartialge that can be used.

Mohsen Tavoussi, MD, DO
Orange County Facial Plastic Surgeon

Revision Rhinoplasty after silicone implant extrusion

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I would recommend waiting 3 months after the silicone implant was removed.  Oftentime, ear or septal cartilage can be used for raising the dorsum (bridge) of the nose.  As always, it is important to communicate your concerns with a board-certified Plastic Surgeon.

Jarrod Little, MD
Louisville Plastic Surgeon
4.9 out of 5 stars 21 reviews

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.