Why implant inflammation recurs, and how staged reconstruction with a resting period is performed

Hello, I am Dr. Peter C. Kang.

Today, I would like to share the case of a patient who visited our clinic after suffering for a long time from recurrent inflammation and implant complications following multiple nasal surgeries.

The patient had previously undergone multiple nasal surgeries at other clinics.

• Approximately 20 years ago: Silicone implant insertion (dissatisfied with the shape)

• Approximately 17 years ago: Silicone implant revision surgery (dissatisfied with the shape)

• Approximately 14 years ago: Silicone implant and ear cartilage surgery (subsequent inflammation developed, along with recurrent acne on the nasal dorsum)

• Approximately 10 years ago: Removal of the silicone implant

• Approximately 10 years ago (about 6 months after removal): Reinsertion of a silicone implant and ear cartilage

Due to recurrent inflammation caused by the implant over an extended period, the nasal tissues were in a weakened state.

• Resolution of recurrent acne and inflammation on the nasal dorsum

• Correction of the retracted columella and the short-appearing nose

• A natural nasal profile planned with safety in mind, rather than excessive changes

Because this patient had experienced severe inflammation caused by foreign materials during previous surgeries, a staged approach was of utmost importance.

1. Eliminating the cause of inflammation — The existing implant and other foreign materials were completely removed, and the inflamed tissue was meticulously debrided.

2. A sufficient resting period of about 2 years — Time was allowed for the inflammation to subside and the tissues to heal.

3. Tissue regeneration therapy using stem cells — Helped support the recovery of the weakened nasal tissues.

4. Structural reconstruction using donor rib cartilage (reflecting the patient's preference) — Reinforced the central supporting cartilage of the nose, repositioned the lower lateral cartilages, and tied the cartilages to refine the nasal tip shape.

5. Creating the nasal bridge line — A silicone implant was used to achieve a natural dorsal height.

Front view changes

• The causes of recurrent inflammation and dorsal skin issues were resolved

• The short-appearing nose was improved with a much more balanced proportion

Profile view changes

• The retracted columella was naturally corrected

• A smooth, stable nasal bridge line was established

Overall change in impression

• Achieved a natural, refined nasal shape without excessive alterations

For a nose damaged by multiple surgeries and recurrent inflammation, attempting drastic changes in a single procedure carries high risk; instead, a staged approach—first removing the source of inflammation and allowing the tissues sufficient time to heal—is the safer path.

In this type of case, foreign materials and inflamed tissue were debrided, followed by a resting period of approximately 2 years. Stem cell therapy was used to assist in the recovery of weakened tissues, after which a stable structure was reconstructed using donor rib cartilage per the patient's preference. Respecting the patient's preference regarding materials while simultaneously accounting for both nasal function and structural stability was the key.

In revision rhinoplasty where damage has accumulated, meticulous planning tailored to the state of the tissues and an adequate recovery period determine the surgical outcome. NOSELAB will continue to closely examine each patient's condition to provide customized surgeries with safety as our top priority.

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

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