Why an old silicone implant capsule calcifies and causes a dorsal hump and crooked nose

Hello, I am Dr. Peter C. Kang.

I would like to introduce the case of a patient whose dorsal hump and crooked nose, caused by calcification of the silicone capsule from surgery 30 years ago, were reconstructed using autologous rib cartilage.

1991

• L-shaped silicone surgery

Functional issues

• Chronic rhinitis

Aesthetic concerns

• Worsened dorsal hump due to silicone capsule calcification

• Nose appearing crooked

• Drooping tip

• Overall unnatural appearance

Diagnosis of key issues

• Calcification of the capsule around an L-shaped silicone implant over 30 years old

• Dorsal hump formation due to the calcified capsule

• Asymmetry and deformity of the overall nasal structure

• Persistent tissue compression from the aged implant

Special notes

• Tissue changes over a span of 30 years

• Anticipated complex removal process due to the calcified capsule

• Natural nose

• Improvement of crooked nose

• Dorsal hump reduction

• Natural yet refined look

Key objective: removal of the calcified capsule

• Complete removal of the 30-year-old L-shaped silicone implant

• Meticulous removal of the calcified capsule

• Debridement of damaged surrounding tissue

• Establishing a clean surgical field

Structural reconstruction

• Full reconstruction using autologous rib cartilage

• Elevating the drooping nasal tip

• Complete correction of the dorsal hump

• Crooked nose correction

Improvement in shape

• Achieving a natural yet refined look

• A contour harmonious with the patient's face

• Balanced height without being excessive

• Refined tip shape

Functional improvement

• Relief of breathing discomfort caused by rhinitis

Functional improvement

• Marked relief of rhinitis symptoms

• Restoration of smooth breathing function

Front view

• Crooked nose completely corrected

• Natural bridge line

• Balanced overall facial proportions

• Dorsal hump cleanly resolved

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

Profile view

• Elevated, well-defined nasal tip

• Smooth and refined nasal line

• Natural hump correction

• Harmonious facial profile

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

Overall changes

• Naturally defined, prominent nose

• Complete resolution of a 30-year-old problem

• Youthful and sophisticated appearance

• Ideal nasal shape desired by the patient

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

Long-term stability

• Long-term stability using autologous rib cartilage

• Eliminated risk of recurrent capsule calcification

• Adaptation to natural aging

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

This case was a complex revision rhinoplasty addressing long-term complications from an L-shaped silicone implant placed 30 years ago. In particular, it was a very unique presentation where the capsule formed around the silicone had calcified, worsening the dorsal hump and causing the nose to appear crooked.

After a silicone implant is inserted into the body, a capsule naturally forms around it over time. In most cases, this capsule does not cause major problems; however, over the course of 30 years, calcification of the capsule occurred in this patient.

As the calcified capsule hardened, it protruded in the form of a dorsal hump, while also affecting the overall symmetry of the nose and giving it a crooked appearance. This was not an issue that could be resolved simply by removing the implant; it required a complex procedure to meticulously remove the calcified capsule as well.

The most crucial step in surgery was completely removing the 30-year-old L-shaped silicone implant and the calcified capsule. Dissecting an implant and capsule that have been integrated with surrounding tissue for decades demands highly delicate technique, ensuring thorough removal while minimizing trauma to adjacent tissues.

After removal, the compromised structure had to be reconstructed. Using autologous rib cartilage, the drooping nasal tip was elevated and projected, and the dorsal hump was fully corrected to achieve the natural yet refined look the patient wanted.

The greatest advantage of autologous rib cartilage is that, because it is the patient's own tissue, there is minimal risk of rejection or foreign body capsule formation. In addition, it provides robust structural support, which supports a stable result over the long term.

Because the patient had rhinitis, functional improvements were addressed simultaneously.

As a result, the issues that had persisted for 30 years were addressed at their root. The dorsal hump caused by the calcified capsule was completely eliminated, the crooked nose was naturally aligned, and the drooping tip was elevated to create the natural and refined nasal contour the patient had hoped for.

This case demonstrated that even long-term complications from aged implants can be thoroughly resolved through accurate diagnosis and systematic reconstruction. The patient was very pleased that concerns lasting for 30 years were resolved through this single surgery.

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

Thank you.

#closedrhinoplasty #siliconeremoval #autologousribcartilage #capsulecalcification #dorsalhumpcorrection #crookednosecorrection