Why an L-shaped silicone implant gradually causes the nasal tip to become upturned: removal and reconstruction

Hello, I am Dr. Peter C. Kang.

Today, I would like to share a revision rhinoplasty case of a patient whose nasal tip gradually became upturned due to an L-shaped silicone implant inserted about 10 years ago.

The patient underwent rhinoplasty using an L-shaped silicone implant about 10 years ago. Over time, the skin at the nasal tip gradually thinned, and an upward upturned deformity progressively developed.

Due to its structural nature, an L-shaped implant can apply long-term pressure to the nasal tip skin, which can lead to an upturned tip deformity.

• The patient wanted to naturally improve the upturned appearance of the nasal tip.

• Rather than a dramatic change, the patient preferred a natural outcome, and due to significant concerns regarding implant-related complications such as contracture and inflammation, the patient wished to proceed using autologous tissue.

1. Removal of the L-shaped silicone implant: The existing implant was removed.

2. Nasal tip reconstruction using autologous rib cartilage: The patient's autologous rib cartilage was harvested to stably reconstruct the nasal tip structure. Septal correction was also performed together to balance the internal nasal framework.

3. Dermal reinforcement and nasolabial angle correction: The nasal tip skin thinned by the implant was reinforced with dermal tissue, and the nasolabial angle—the angle between the upturned nasal tip and the upper lip—was corrected to improve overall balance.

Front view changes

• The upturned nasal tip shape was naturally corrected, improving into a stable appearance.

• A natural nasal line was created without an artificial look.

Profile view changes

• The angle between the nasal tip and the upper lip improved with balanced proportions.

• As the excessively upturned nasal tip was brought down to a comfortable position, the profile line became natural.

Overall change in impression

• With the nasal tip stably repositioned, the overall balance became more natural.

Because an L-shaped implant structurally extends to support the nasal tip, the nasal tip skin can thin over time, and the implant can be pushed upward, resulting in an upturned deformity. In severe cases, there is a risk of the implant extruding through the skin, so if such a deformity is progressing, removal and reconstruction should be considered in a timely manner.

Using autologous rib cartilage in cases like this reduces foreign body reactions while providing stable support for the nasal tip, and reinforcing the thinned skin with dermis helps achieve a long-term natural appearance.

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

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