Implant Visibility Revision Rhinoplasty with Rib Cartilage Reconstruction
- Dr. Chayoung Kang
- 2일 전
- 6분 분량
This case reviews implant visibility revision rhinoplasty in a patient who developed implant show-through, nasal asymmetry, thin nasal tip skin, and an overly sharp tip contour after prior rhinoplasty. Surgery focused on implant removal, autologous rib cartilage reconstruction, septal rebuilding, nasolabial angle adjustment, and soft tissue reinforcement with artificial dermis.
Author: Dr. Cha-Young Kang
Clinic: NoseLab Clinic
Published: 2026
Last Updated: 2026
Introduction
Hello, this is Dr. Cha-Young Kang of NoseLab Clinic.
This case involves implant visibility revision rhinoplasty in a patient who previously underwent rhinoplasty with a silicone implant and ear cartilage graft.
Over time, the patient began to notice that the silicone implant could be felt at the nasal tip. As the tip skin became thinner, cartilage and implant contour became visible through the skin. The tip also appeared overly sharp, and surrounding tissue tension contributed to visible asymmetry.
The patient wanted a softer, rounder, and more natural-looking nose rather than a dramatic or overly sharp result. The goal of surgery was to remove the problematic implant, rebuild the nasal tip with autologous tissue, improve asymmetry, and create a more balanced overall contour.
The surgery was performed using a closed rhinoplasty / endonasal approach.
Surgical History
The patient had a history of both filler treatment and prior rhinoplasty.
5 years ago: Nasal filler treatment, later removed during rhinoplasty
3 years ago: Rhinoplasty at another clinic using a silicone implant and ear cartilage
1 year ago onward: Silicone became palpable at the nasal tip, followed by progressive thinning of the tip skin, visible contour irregularity, and asymmetry
These changes suggested implant-related pressure on the soft tissue, progressive thinning of the nasal tip skin, and structural imbalance after the previous surgery.
Preoperative Assessment
Preoperative design consultation photos were reviewed from the frontal, side, oblique, and nostril views.
Frontal View
From the frontal view, the nose showed asymmetry related to soft tissue tension and structural imbalance.
The tip contour appeared overly defined and unnatural, and the lower nose lacked softness.
Side View
From the side profile, the tip looked excessively sharp rather than naturally rounded.
The lower nasal angle also appeared imbalanced, contributing to a less relaxed overall profile.
Tip Skin Condition
The nasal tip skin had become thin after prior surgery.
Because of this, underlying cartilage and implant contour became visible, raising concern for long-term soft tissue safety and aesthetic instability.
Overall Structural Considerations
Revision rhinoplasty in this setting required careful evaluation of prior scar tissue, implant-related tension, skin thinning, and septal support.
The surgical plan therefore focused not only on changing the visible shape, but also on rebuilding stable internal support and reinforcing the soft tissue envelope.
Patient Concerns and Goals
The patient’s main goals were as follows:
To make the nasal tip slightly rounder and more natural
To avoid an overly sharp or dramatic appearance
To improve asymmetry and create a more balanced nasal shape
To achieve a softer and more comfortable overall impression
Rather than seeking a dramatic increase in height or projection, the patient wanted a stable and natural revision result that better matched the rest of the face.
Surgical Plan
1. Removal of the Existing Silicone Implant
The silicone implant placed during the previous surgery was removed.
Because the implant had become palpable and contributed to tip thinning and visibility, removal was necessary to reduce pressure on the soft tissue and create a safer foundation for revision.
2. Nasal Tip Reconstruction with Autologous Rib Cartilage
The patient’s own rib cartilage was selectively sliced and used to reconstruct the nasal tip framework.
Autologous rib cartilage was chosen to provide stronger long-term support while allowing the tip to be shaped in a softer and more natural way.
This helped replace the prior sharp contour with a rounder and more balanced tip shape.
3. Septal Reconstruction for Structural Stability
Septal reconstruction was performed to restore structural support in the central nasal framework.
This step helped secure long-term tip stability and allowed controlled adjustment of the lower nasal angle.
4. Nasolabial Angle Adjustment
The angle between the nose and upper lip was adjusted to improve lower facial balance.
This helped soften the overall side profile and reduce the overly tense or sharp appearance of the lower nose.
5. Soft Tissue Reinforcement with Artificial Dermis
Because the tip skin had become thin after the previous surgery, artificial dermis was used to reinforce the soft tissue.
Soft tissue reinforcement was important to improve coverage over the reconstructed tip, reduce visible contour show-through, and support a smoother external appearance.
Surgical Results After Implant Visibility Revision Rhinoplasty
Frontal View Changes
After surgery, the nasal tip appeared rounder and more natural from the frontal view.
Left-right asymmetry was reduced, and the overall nasal shape appeared more balanced.
Side View Changes
From the side profile, the lower nasal angle appeared more natural after adjustment.
The previously sharp and tense appearance of the tip became softer, contributing to a more relaxed nasal line.
Overall Aesthetic Change
The overall impression became softer and less artificial.
Rather than looking overly projected or sharply defined, the nose appeared more balanced and naturally integrated with the rest of the face.
Structural and Soft Tissue Stability
By removing the implant, rebuilding the tip with rib cartilage, reconstructing septal support, and reinforcing thin skin with artificial dermis, the surgery addressed both the structural and soft tissue causes of the original problem.
Surgeon’s Commentary
Revision rhinoplasty requires a more delicate approach than primary rhinoplasty because of scar tissue, tissue adhesion, prior implant placement, and changes in skin quality.
In patients who have had an implant in place for a long time, the skin may gradually thin, and the implant or cartilage may begin to show through. In those cases, simply reshaping the outside is not enough. The underlying cause must be addressed.
In this case, implant removal was important for long-term safety. The nasal tip was then reconstructed using autologous rib cartilage, which provided more reliable structural support. At the same time, artificial dermis was used to reinforce the thin tip skin and improve soft tissue coverage.
The goal was not to create an exaggerated nose, but to produce a softer and more natural result that matched the patient’s preferences while improving structural stability.
This case shows that implant visibility revision rhinoplasty may require combined treatment of implant-related thinning, asymmetry, septal weakness, and soft tissue deficiency.
FAQ
Why does implant visibility happen after rhinoplasty?
Implant visibility may develop when the implant places long-term pressure on thin nasal skin, when the implant contour is too strong for the patient’s soft tissue thickness, or when tissue changes occur after previous surgery.
Is implant removal always necessary in these cases?
Not always, but removal may be necessary when the implant becomes palpable, visible, poorly positioned, or associated with thinning skin and structural imbalance.
Why is rib cartilage used in revision rhinoplasty?
Autologous rib cartilage may be used when stronger support is needed, especially in revision cases with structural weakness, prior cartilage loss, or the need for stable tip reconstruction.
What is the role of artificial dermis in this surgery?
Artificial dermis may be used to reinforce thin soft tissue, improve coverage over reconstructed cartilage, and reduce the risk of contour show-through.
Can asymmetry improve after revision rhinoplasty?
Yes, asymmetry may improve when the underlying structural imbalance and soft tissue tension are corrected. The degree of improvement depends on each patient’s anatomy, scar tissue, and healing response.
International Consultation
For international patients, a photo-based consultation may help clarify whether implant visibility revision rhinoplasty, rib cartilage reconstruction, septal rebuilding, asymmetry correction, or soft tissue reinforcement may be needed.
WhatsApp: https://wa.me/821057360302
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Medical Disclosure
Surgical before-and-after photos show individual patient cases, and results may vary depending on each patient’s anatomy, previous surgical history, implant condition, skin thickness, scar tissue, cartilage availability, soft tissue condition, and healing process. Please consult your doctor for an individualized assessment.
After surgery, complications may occur, including infection, bleeding, inflammatory reaction, asymmetry, limited aesthetic improvement, limited functional improvement, implant-related problems, skin problems, scarring, graft visibility, cartilage warping, persistent contour irregularity, delayed healing, or other complications.
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