Hello, this is Dr. Cha-Young Kang, Director of Nose Lab Clinic.
Today, I’d like to share a revision rhinoplasty case involving a female patient who came to us with complications related to a silicone implant. This case highlights some of the potential risks associated with silicone implants and the steps taken to achieve a safe, natural outcome.
Design Consultation: Frontal View, Left Oblique Side View, and Side View Photos
Right Oblique Side View, Side View, and Nostril View Photos
1. Patient Background and Symptoms
Surgical History:
Initial surgery in 2009 with a silicone implant and osteotomy
Primary Symptoms:
Redness and swelling at the nasal tip starting four years ago, worsening with fatigue
Nasal obstruction
Diagnostic Findings: A CT scan at our clinic revealed:
The silicone implant was positioned directly beneath the nasal tip skin.
Deviated nasal septum
Hypertrophic rhinitis
This photo shows the silicone implant extending to the nasal tip, causing complications.
A deviation of the nasal septum to the left is observed.
A deviation of the nasal septum to the right and hypertrophy of the bilateral inferior turbinates are observed.
The redness and swelling were signs of a foreign body reaction to the silicone implant. If untreated, this could lead to the implant pressing through the skin, causing severe complications.
2. Surgical Plan
The revision surgery aimed to address both functional and aesthetic concerns:
Septal Extension and Reconstruction with Autologous Rib Cartilage: Reconstructing lost cartilage and stabilizing the nose.
Silicone Removal and New Implant Placement: Replacing the old implant with a shorter implant placed only along the bridge to limit foreign body exposure.
Septoplasty: Correcting the septal deviation to improve nasal airflow.
Turbinate Reduction with Radiofrequency Laser: Treating hypertrophic rhinitis for improved breathing.
Intraoperative Findings and Procedure
During surgery, we observed:
Significant damage to the septal cartilage due to the prior surgery, requiring full reconstruction.
Chronic inflammation in the nasal tip caused the absorption of parts of the nasal tip cartilage and septal cartilage.
We reconstructed the nasal tip with rib cartilage to restore structural integrity.
The patient’s desire for a natural look was addressed by maintaining the existing nasal shape, correcting the upturned tip and columella retraction, and refining the nasolabial angle.
Before (Left) / Immediately After (Right)
Before (Left) / Immediately After (Right)
Before (Left) / Immediately After (Right)
Before (Left) / Immediately After (Right)
3. Post-Surgical Results
The outcome successfully addressed both aesthetic and functional issues:
Resolved Redness and Swelling: The inflammatory response at the tip subsided.
Improved Breathing: Septoplasty and turbinate reduction greatly alleviated nasal obstruction.
Natural Appearance: The nasal shape was refined while maintaining a balanced, natural look.
Safe Implant Position: The new implant was limited to the bridge, reducing future risk of complications.
Immediately After Surgery: Frontal, Oblique Side, and Side Views
Immediately After Surgery: Nostril View
4.Final Thoughts
To achieve safe and lasting results in rhinoplasty, silicone implants should ideally be used minimally and placed only along the bridge to avoid direct skin contact in sensitive areas like the nasal tip.
At Nose Lab Clinic, patient safety and satisfaction are always our top priorities. If you’re considering rhinoplasty, consulting with a specialist is essential to choosing the safest and most effective approach tailored to your unique needs.
If you have any questions, please feel free to leave a comment. We’re here to provide answers and support.
Thank you,
Dr. Cha-Young Kang, Director of Nose Lab Clinic
コメント