L-Shaped Silicone Implant Removal and Natural Nasal Reconstruction with Autologous Rib Cartilage

Hello,

This is Dr. Cha-Young Kang, medical director of NOSELAB Plastic Surgery Clinic.

Today, I’d like to share a case involving a patient who experienced serious complications from an L-shaped silicone implant and required safe L-shaped silicone implant removal followed by reconstruction using autologous rib cartilage. She came to our clinic complaining that her nose had become noticeably shorter and overly upturned. Upon examination, we found that the implant tip was nearly perforating the left columellar mucosa—a condition requiring immediate attention.

Common Complications from L-Shaped Silicone Implants

Preoperative design consultation photos: Frontal view, left oblique side view, and left side view.

This patient had previously undergone rhinoplasty using an L-shaped silicone implant at another clinic. However, over time, several problems occurred:

• Shortened, upturned nasal tip

• Implant pressure causing near-mucosal perforation

• Thinning and weakening of nasal tip skin

• Loss of natural nasal contour and artificial appearance

The L-shaped silicone implant extends to the nasal tip and is highly rigid. Continuous pressure from the implant can lead to thinning of the skin, mucosal damage, and even extrusion of the implant through the skin or mucosa. These are among the most common reasons patients seek L-shaped silicone implant removal and reconstructive surgery.

Preoperative design consultation photos: Right side view, right oblique side view, and nostril view.

Safe L-Shaped Silicone Implant Removal and Reconstruction Using Autologous Rib Cartilage

In this case, simple implant removal was not enough. A full reconstructive approach was required to restore both function and aesthetics after the L-shaped silicone implant removal.

1. Safe L-Shaped Silicone Implant Removal

• The implant was carefully extracted to prevent mucosal perforation.

• The surrounding tissues were assessed and preserved during surgery.

2. Septal Extension with Autologous Rib Cartilage

• The patient’s own rib cartilage was used to rebuild the nasal framework.

• Provided strong, stable support for long-term results.

• Helped achieve a more natural nasal tip shape and position.

3. Reinforcement of Thinned Nasal Tip Skin with Autologous Dermis

• The thinned nasal tip skin was reinforced using dermal grafts from the patient’s own tissue.

• Prevented future skin breakdown or exposure.

• Maintained a soft, natural texture and improved durability.

4. Functional Improvement

• Strengthened septal support and improved nasal airway function.

Surgical Outcome after L-Shaped Silicone Implant Removal

Results:

• Complete and safe L-shaped silicone implant removal

• Natural repositioning of the previously upturned nasal tip

• Strengthened nasal tip structure and improved skin thickness

• Enhanced nasal breathing and stable long-term result

By using autologous rib cartilage, we achieved a natural, long-lasting reconstruction without the complications associated with synthetic materials.

Before Surgery (Left) / Immediately After Surgery (Right)

Before Surgery (Left) / Immediately After Surgery (Right)

Before Surgery (Left) / Immediately After Surgery (Right)

Before Surgery (Left) / Immediately After Surgery (Right)

Expert Commentary on L-Shaped Silicone Implant Removal

Although L-shaped silicone implants were commonly used in the past, they are now strongly discouraged among experienced plastic surgeons due to the high risk of complications.

Problems with L-Shaped Silicone Implants:

• Constant pressure on the nasal tip from the rigid implant

• Progressive shortening and upturning of the nasal tip

• Skin thinning, implant visibility, or extrusion

• Impaired blood circulation to nasal tip skin and mucosa

If left untreated, the implant may eventually erode through the skin or mucosa, leading to infection or deformity.

Early and safe L-shaped silicone implant removal is crucial to prevent such severe outcomes.

Advantages of Autologous Rib Cartilage Reconstruction:

• No risk of rejection (patient’s own tissue)

• Ample structural support for long-term stability

• Natural appearance with minimal complications

Benefits of Autologous Dermal Grafts:

• Safely reinforces thin skin

• Reduces the risk of future complications

• Maintains soft and natural texture of the nasal tip

At NOSELAB, our approach to L-shaped silicone implant removal focuses on both safety and aesthetics. By combining precise removal techniques with autologous tissue reconstruction, we achieve stable, natural, and sustainable outcomes.

If you are experiencing discomfort or deformity caused by an L-shaped silicone implant, consult a qualified specialist before the condition worsens.

Thank you for reading.– Dr. Cha-Young Kang,

Postoperative precautions and possible complications after rhinoplasty

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