Hello, I am Dr. Peter C. Kang.

Today, I would like to share the case of a patient who underwent urgent revision rhinoplasty due to the risk of silicone extrusion.

When a silicone implant is about to push through the nasal tip skin: why it happens and how to reconstruct it — Front, left profile, and oblique views during design consultation
When a silicone implant is about to push through the nasal tip skin: why it happens and how to reconstruct it — Front, left profile, and oblique views during design consultation
When a silicone implant is about to push through the nasal tip skin: why it happens and how to reconstruct it — Front, left profile, and oblique views during design consultation

Front, left profile, and oblique views during design consultation

📍 Surgical history

  • 3 years ago: Dissolvable filler injection

  • 2 years ago: Rhinoplasty with septal cartilage and a silicone implant

  • 8 months after surgery: Medical treatment for suspected symptoms of inflammation

🔎 Initial consultation findings

When a silicone implant is about to push through the nasal tip skin: why it happens and how to reconstruct it — Design consultation photos: nostril, right profile, and oblique views
When a silicone implant is about to push through the nasal tip skin: why it happens and how to reconstruct it — Design consultation photos: nostril, right profile, and oblique views
When a silicone implant is about to push through the nasal tip skin: why it happens and how to reconstruct it — Design consultation photos: nostril, right profile, and oblique views

Design consultation photos: nostril, right profile, and oblique views

  1. Skin condition

  • Redness at the nasal tip

  • Imminent silicone implant extrusion

  • Thinned skin

2. External appearance

  • Excessive nostril show from the front view

  • High glabella

  • Upturned nasal tip

  • Nostril asymmetry

3. Endoscopic examination

  • Left septal deviation

  • Bilateral inferior turbinate hypertrophy

  • Left nasal mucosal synechia (adhesion)

When a silicone implant is about to push through the nasal tip skin: why it happens and how to reconstruct it — Nasal endoscopy (left) and intraoperative view showing the mucosal adhesion in the left nasal cavity (right)
When a silicone implant is about to push through the nasal tip skin: why it happens and how to reconstruct it — Nasal endoscopy (left) and intraoperative view showing the mucosal adhesion in the left nasal cavity (right)

Nasal endoscopy (left) and intraoperative view showing the mucosal adhesion in the left nasal cavity (right)

✨ Patient's requests

💉 Surgical procedure details

Before surgery / Day 0 immediately after surgery Photos taken immediately after surgery show swelling and may differ from the final result.

  1. Emergency intervention

  • Complete removal of the existing silicone implant

  • Irrigation of the inflamed area

  • Debridement of damaged tissue

When a silicone implant is about to push through the nasal tip skin: why it happens and how to reconstruct it — A photo showing how the silicone implant had descended directly beneath the nasal tip skin, just on the verge of puncturing through.
When a silicone implant is about to push through the nasal tip skin: why it happens and how to reconstruct it — A photo showing how the silicone implant had descended directly beneath the nasal tip skin, just on the verge of puncturing through.

A photo showing how the silicone implant had descended directly beneath the nasal tip skin, just on the verge of puncturing through.

2. Reconstruction surgery

  • Nasal tip reconstruction using autologous rib cartilage

  • Reinforcing thinned skin with a dermal graft

  • Establishing an active antibiotic treatment protocol

3. Shape improvement

  • Correction of upturned nose

  • Natural contour between the eyebrows (glabella)

  • Improved nostril shape

✅ Surgical results

Before surgery / Day 0 immediately after surgery Photos taken immediately after surgery show swelling and may differ from the final result.

  1. Front view

  • Excessive nostril show was improved

  • Natural glabellar height

  • Stable nasal tip position

When a silicone implant is about to push through the nasal tip skin: why it happens and how to reconstruct it — Before surgery / day 0 immediately after surgery. Photos taken immediately after surgery include swelling and may differ from the final result.
When a silicone implant is about to push through the nasal tip skin: why it happens and how to reconstruct it — Before surgery / day 0 immediately after surgery. Photos taken immediately after surgery include swelling and may differ from the final result.

Before surgery / Day 0 immediately after surgery Photos taken immediately after surgery show swelling and may differ from the final result.

2. Profile view

  • More natural radix

  • Well-defined nasal tip line

  • Smooth profile line

Before surgery / Day 0 immediately after surgery Photos taken immediately after surgery show swelling and may differ from the final result.

3. Skin condition

  • Improvement of thinned nasal tip skin through dermal reinforcement

  • Resolution of skin redness

  • Stabilized tissue condition

Before surgery / Day 0 immediately after surgery Photos taken immediately after surgery show swelling and may differ from the final result.

👨⚕️ Specialist's assessment

When a silicone implant is about to push through the nasal tip skin: why it happens and how to reconstruct it — Photos immediately after surgery (day 0): front, profile, and oblique views. Photos taken immediately after surgery show swelling and may differ from the final result.
When a silicone implant is about to push through the nasal tip skin: why it happens and how to reconstruct it — Photos immediately after surgery (day 0): front, profile, and oblique views. Photos taken immediately after surgery show swelling and may differ from the final result.
When a silicone implant is about to push through the nasal tip skin: why it happens and how to reconstruct it — Photos immediately after surgery (day 0): front, profile, and oblique views. Photos taken immediately after surgery show swelling and may differ from the final result.

Front, profile, and oblique views immediately after surgery on day 0 Photos taken immediately after surgery show swelling and may differ from the final result.

Nostril view on day 0 immediately after surgery Photos taken immediately after surgery show swelling and may differ from the final result.

This was an urgent situation where silicone extrusion was imminent. Prompt silicone removal combined with reconstruction using autologous rib cartilage and skin reinforcement with a dermal graft resolved the risk factors. In particular, alongside the recovery of the thinned skin tissues, an aesthetically pleasing result was achieved.

This was Dr. Peter C. Kang. Thank you.

Thank you.

#closedrhinoplasty #revisionrhinoplasty #autologousribcartilage #siliconeremoval #customrhinoplasty

Limitations and risks

When autologous rib cartilage is used, scarring and pain may remain at the donor site on the chest, and pneumothorax (pleural injury) can occur rarely. Over time, the grafted cartilage may warp or undergo partial resorption.

When revising after implant removal, contracture may progress again after removal, the nasal height and length may decrease, and staged surgery may be necessary depending on the skin condition.

When the septum is corrected at the same time, nasal obstruction may persist or recur, and in rare cases, septal perforation or changes in smell may occur.

Common potential risks include infection, bleeding, asymmetry, scarring, skin necrosis, and insufficient improvement; results vary depending on individual skin condition and previous surgical history.

Read original on Naver ↗