Why silicone implants deviate and make the nose look long: implant replacement and rib cartilage reconstruction

Hello, I am Dr. Peter C. Kang.

Today, I would like to introduce the case of a male patient who had long been concerned about his small nose and had undergone two rhinoplasties elsewhere, but visited our clinic because he was not satisfied with the outcomes.

• Approximately 10 years ago: Rhinoplasty using a silicone implant and ear cartilage at another clinic → deviation of the silicone implant occurred

• Approximately 5 years ago: Revision rhinoplasty using a 3D silicone implant, septal cartilage, and ear cartilage at another clinic

• Wished to reduce nostril show from the front

• Wished to improve the elongated appearance of the nose

• Wished to lower the radix

• Wished to further elevate the nose

• Requested a customized implant due to previous experience with silicone deviation

1. Complete removal of existing implants

• Complete removal of the silicone implant from the nasal bridge and implants used in previous surgeries

• Established a reconstruction plan after evaluating internal conditions

2. Correction of the nasal radix starting point

• Naturally lowered the radix, taking into account the limited skin elasticity

• Improved the overly elongated appearance of the nose

3. Nasal tip reconstruction using autologous rib cartilage

• Naturally lowered the upturned nasal tip

• Achieved maximum elevation within a safe range to create a harmonious line

4. Correction of nasolabial angle

• Corrected the angle between the nose and the upper lip

• Improvement of the profile silhouette

5. Placement of a customized implant

• Used a customized implant precisely fabricated to match the contours of the patient's nasal bone

• Formation of a natural bridge line

• Prevented recurrent deviation of the silicone implant

6. Relief of nasal obstruction

• Correction of deviated septum

• Simultaneously performed rhinitis surgery to improve respiratory function

Front view changes:

• The radix was naturally lowered, improving overall facial proportions

• Decreased nostril show

• Overall balanced nasal shape

Profile view changes:

• The previously upturned nasal tip was corrected to a natural position

• A natural nasal bridge line was achieved with maximum height within a safe range

• A refined profile silhouette was created through nasolabial angle correction

Functional improvement:

• Restored breathing function through correction of the deviated septum

• Improvement in chronic nasal obstruction through rhinitis surgery

Rhinoplasty for a small nose is not simply about adding height. Particularly when skin elasticity is limited, the key is not to force excessive height, but to comprehensively adjust the radix, tip position, and nasolabial angle to achieve a natural transformation.

In this case, with a history of two previous surgeries, it was crucial to meticulously assess the internal tissue. After removing all existing implants, the nasal tip was stably reconstructed with autologous rib cartilage, and the nasal bridge line was naturally shaped using a customized implant.

Choosing a customized implant given the patient's prior experience with silicone deviation was also a meaningful decision in preventing recurrence. Using an implant tailored precisely to the patient's nasal bone structure helps reduce the risk of movement or displacement.

I hope this case is helpful to those with similar concerns. This has been Dr. Peter C. Kang, Medical Director. Thank you.

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