L-Shaped Silicone Implant Removal Rhinoplasty
- Dr. Chayoung Kang
- 7월 14일
- 7분 분량
This case reviews L-shaped silicone implant removal rhinoplasty in a patient who developed progressive nasal tip elevation, thinning nasal tip skin, upturned tip deformity, concern about implant-related complications, and lower nasal imbalance after previous rhinoplasty with an L-shaped silicone implant. Surgery focused on L-shaped implant removal, autologous rib cartilage tip reconstruction, septal correction, dermal graft reinforcement for thin tip skin, nasolabial angle correction, and closed rhinoplasty structural support.
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 L-shaped silicone implant removal rhinoplasty in a patient who had undergone rhinoplasty with an L-shaped silicone implant more than 10 years earlier.
Over time, the nasal tip skin became thinner, and the nasal tip gradually rotated upward. The patient was concerned about the upturned nasal tip appearance and possible implant-related problems such as contracture, inflammation, or progressive skin thinning.
Because an L-shaped silicone implant can place long-term pressure on the nasal tip, careful evaluation of skin thickness, implant position, tip support, and lower nasal structure was necessary before revision surgery.
The surgery was performed using a closed rhinoplasty / endonasal approach. The goal was to remove the L-shaped silicone implant, rebuild nasal tip support with autologous rib cartilage, reinforce the thin tip skin with dermal tissue, and adjust the nasolabial angle within the patient’s anatomical limits.
Surgical History Before L-Shaped Silicone Implant Removal Rhinoplasty
The patient had undergone rhinoplasty with an L-shaped silicone implant more than 10 years earlier.
As time passed, the nasal tip skin gradually became thinner, and the nasal tip appeared increasingly upturned.
This type of change can occur when implant pressure affects the nasal tip soft tissue over a long period.
Because the implant extended toward the nasal tip, the surgical plan needed to consider not only implant removal but also reconstruction of the lower nasal framework after removal.
Patient Concerns Before L-Shaped Silicone Implant Removal Rhinoplasty
The patient’s main concerns were:
Upturned nasal tip appearance
Progressive thinning of the nasal tip skin
Concern about implant-related complications
Preference for autologous tissue reconstruction
Desire for a natural-looking change rather than a dramatic transformation
Lower nasal imbalance involving the tip and upper lip angle
The patient wanted to improve the lifted nasal tip shape while avoiding excessive change.
Because the patient was concerned about implant-related problems, the revision plan focused on using autologous rib cartilage for nasal tip reconstruction.
Preoperative Assessment Before L-Shaped Silicone Implant Removal Rhinoplasty
Preoperative design consultation photos were reviewed from the frontal, side, oblique, and nostril views.
Frontal View: Upturned Tip and Lower Nasal Balance
From the frontal view, the lower nasal structure showed signs of tip elevation.
The nasal tip appeared affected by long-term implant pressure and soft tissue thinning.
Lower nasal balance was evaluated together with nostril exposure, columella position, and tip support.
Side View: Thin Tip Skin and Nasolabial Angle
From the side profile, the nasal tip appeared lifted, and the angle between the nasal tip and upper lip required correction.
The nasal tip skin appeared thin, which required careful planning for soft tissue reinforcement.
Because tip skin thinning can increase the risk of implant visibility or skin-related problems, dermal reinforcement was included in the surgical plan.
Oblique View: Implant-Related Tip Tension
From the oblique view, the relationship between the nasal bridge, tip, and columella was evaluated.
Long-term implant pressure can create tension in the nasal tip area and contribute to an upturned appearance.
Nostril View: Lower Nasal Framework
From the nostril view, the lower nasal framework was evaluated for support, symmetry, and tip position.
Because nostril shape can be affected by tip rotation, septal support, columella position, scar tissue, and healing response, correction was planned within realistic tissue limits.
Surgical Plan for L-Shaped Silicone Implant Removal Rhinoplasty
1. Removal of the L-Shaped Silicone Implant
The existing L-shaped silicone implant was removed.
Because the implant had been placing pressure on the nasal tip area over time, removal was an important step before reconstruction.
After removal, the lower nasal structure needed to be rebuilt to avoid collapse or insufficient tip support.
2. Nasal Tip Reconstruction with Autologous Rib Cartilage
Autologous rib cartilage was harvested and used to reconstruct the nasal tip framework.
Rib cartilage was selected because the revision required stronger support for the nasal tip after implant removal.
This step helped support the nasal tip and improve lower nasal structure without relying on the previous L-shaped implant.
3. Septal Correction for Internal Structural Balance
Septal correction was performed together with nasal tip reconstruction.
This helped improve internal structural balance and support the central nasal framework.
Septal condition is important in revision rhinoplasty because the nasal tip and lower nasal framework depend on stable central support.
4. Dermal Graft Reinforcement for Thin Tip Skin
Because the nasal tip skin had become thin after long-term implant pressure, dermal tissue was used to reinforce the soft tissue layer.
Dermal reinforcement was planned to improve coverage over the reconstructed nasal tip and reduce the risk of visible contour show-through.
The response to dermal reinforcement may vary depending on skin thickness, scar tissue, tissue quality, and healing process.
5. Nasolabial Angle Correction
The nasolabial angle, which refers to the angle between the nasal tip and upper lip, was adjusted.
This helped improve the relationship between the upturned nasal tip, columella, and upper lip.
The goal was a more balanced lower nasal profile rather than excessive lowering or dramatic shape change.
Surgical Results After L-Shaped Silicone Implant Removal Rhinoplasty
Frontal View: Tip Position and Nasal Balance
From the frontal view, the upturned tip appearance appeared improved after implant removal and rib cartilage reconstruction.
The nasal line appeared more natural-looking after lower nasal support was rebuilt.
The overall nasal balance appeared improved within the patient’s anatomical limits.
Side View: Nasolabial Angle and Tip Rotation
From the side profile, the angle between the nasal tip and upper lip appeared more balanced after nasolabial angle correction.
The excessively lifted nasal tip appeared lower and better supported after autologous rib cartilage reconstruction.
The side profile appeared softer after dermal reinforcement and lower nasal framework correction.
Oblique View: Lower Nasal Contour
From the oblique view, the transition from the nasal bridge to the nasal tip appeared more balanced.
The lower nasal contour appeared less tense after L-shaped implant removal and tip reconstruction.
Nostril View: Lower Nasal Framework Support
From the nostril view, lower nasal support appeared improved after septal correction and rib cartilage reconstruction.
Because nostril shape and tip position can change during healing, final evaluation should be made over time.
Skin and Soft Tissue Support
The thin nasal tip skin was reinforced with dermal tissue.
This was planned to provide additional soft tissue coverage over the reconstructed tip framework.
Skin condition should continue to be monitored during recovery because long-term implant pressure can affect tissue quality.
Surgeon’s Commentary on L-Shaped Silicone Implant Removal
An L-shaped silicone implant extends from the bridge to the nasal tip. Because of this structure, it can place pressure on the nasal tip skin over time.
In some patients, long-term pressure may lead to thinning of the tip skin, implant visibility, inflammation, contracture, tip elevation, or risk of skin compromise.
When the nasal tip begins to lift or the skin becomes thin, revision planning should consider both implant removal and structural reconstruction.
Simply removing the implant may not be enough because the nasal tip may lose support after removal.
In this case, autologous rib cartilage was used to rebuild nasal tip support, and dermal tissue was used to reinforce the thin nasal tip skin.
Septal correction and nasolabial angle adjustment were performed to improve the lower nasal profile and internal structural balance.
This case shows that L-shaped silicone implant removal rhinoplasty may require combined correction of implant-related pressure, upturned tip deformity, thin skin, septal support, and lower nasal framework stability.
All surgical planning should be individualized based on implant type, implant position, skin thickness, inflammation history, contracture status, cartilage availability, and healing response.
FAQ
Why can an L-shaped silicone implant cause an upturned tip?
An L-shaped silicone implant extends into the nasal tip area and may place long-term pressure on the tip skin and soft tissue. Over time, this can contribute to skin thinning, tension, and upward tip deformity in some patients.
Is implant removal alone enough?
Not always. If the nasal tip support is weakened or the skin is thin, reconstruction may be needed after implant removal to support the lower nasal framework.
Why was rib cartilage used in this revision surgery?
Autologous rib cartilage may be used when stronger support is needed for nasal tip reconstruction, especially after implant removal or in revision cases with structural weakness.
Why is dermal graft reinforcement used?
Dermal graft reinforcement may be used when the nasal tip skin is thin and additional soft tissue coverage is needed over the reconstructed framework.
Can nasolabial angle correction improve an upturned nasal tip?
Nasolabial angle correction can help improve the relationship between the nasal tip, columella, and upper lip. The degree of change depends on tissue condition, cartilage support, and healing response.
International Consultation
For international patients, a photo-based consultation may help clarify whether L-shaped silicone implant removal rhinoplasty, upturned nasal tip correction, autologous rib cartilage tip reconstruction, dermal graft rhinoplasty, nasolabial angle correction, septal correction, or closed rhinoplasty Korea 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 type, implant position, duration of implant placement, skin thickness, inflammation history, contracture status, septal condition, cartilage availability, dermal tissue condition, nostril shape, and healing process. Please consult your doctor for an individualized assessment.
After surgery, complications may occur, including infection, bleeding, inflammatory reaction, allergic reaction, asymmetry, limited aesthetic or functional improvement, excessive scarring, skin problems, necrosis, graft visibility, cartilage warping, implant-related problems, persistent skin thinning, recurrent upturned tip, nostril asymmetry, contour irregularity, delayed healing, or other complications.
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