Why an implant is palpable and visible through the nasal tip: rib cartilage reconstruction and dermis reinforcement

Hello, I am Dr. Peter C. Kang.

Today, I would like to share the case of a patient who underwent revision rhinoplasty due to implant show-through and asymmetry following a previous rhinoplasty.

The patient had received nasal filler 5 years ago, which was removed during a subsequent rhinoplasty.

3 years ago, the patient underwent rhinoplasty at another clinic using a silicone implant and ear cartilage, and starting 1 year ago, the silicone implant began to be felt at the nasal tip.

Subsequently, as the nasal tip skin progressively thinned, the cartilage showed through, the tip appeared excessively sharp, and asymmetry developed as the surrounding tissue appeared pulled.

• The patient wanted to make the nasal tip slightly rounder and more natural than it was.

• Rather than a dramatic or sharp feel, the patient desired a soft, natural nasal line.

• The patient wanted to improve the asymmetry to create a well-balanced nasal shape.

• Overall, the patient wanted a natural nasal line and a relaxed, comfortable impression.

The silicone implant placed during the previous surgery was removed, and the nasal tip structure was newly reconstructed using selectively sliced autologous rib cartilage from the patient. Utilizing autologous tissue supported long-term stability and achieved a natural result.

1. The silicone implant was removed, and the nasal tip structure was reconstructed using autologous rib cartilage.

2. Through septal reconstruction, structural stability of the nose was secured, and the lower nasal angle (nasolabial angle) was naturally corrected.

3. The nasal tip skin thinned by the previous surgery was reinforced using artificial dermis.

Front view changes

• The nasal tip was improved to a rounder and more natural shape.

• The left-right asymmetry was alleviated, changing into a well-balanced nasal shape.

Profile view changes

• The lower nasal angle was naturally corrected, softening the overall nasal line.

• The shape was improved to give a comfortable impression rather than a sharp one.

Overall change in impression

• With an unexaggerated, natural nasal shape, the overall impression became noticeably softer.

Revision rhinoplasty requires a more delicate approach than primary surgery due to tissue changes from previous procedures, scarring, and adhesions between implants and surrounding tissues. In particular, when an implant is retained for a long period, issues such as thinning skin and implant show-through can occur.

In such cases, removing the implant and replacing it with autologous tissue is important for long-term safety. In cases like this, reconstructing the nasal tip using the patient's own rib cartilage along with reinforcing the skin with artificial dermis achieved a natural result.

If you are considering revision rhinoplasty, please establish a surgical plan suited to your condition through a thorough consultation with your surgeon.

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

#closedrhinoplasty #closedrevisionrhinoplasty #revisionrhinoplasty #autologousribrhinoplasty #implantremoval #nasaltipreconstruction #asymmetrycorrection #septalreconstruction #artificialdermis