Can My Silicone Nasal Implant Be Removed?
Q: Dr. Eppley, I was 16 years old when I got my rhinoplasty done. I am Asian and I had what appears to be a very typical Asian rhinoplasty using an implant. I think it is a silicone L-shaped implant. I originally had a very flat nose with a low bridge. It is now 20 years later and I want to take it out. I have never liked the way it feels and the idea of having plastic in my face bothers me. I think the skin has also gotten thin over it as I think I can see the implant when out in bright sunshine. Can it be removed at this point? How will my nose look when it comes out?
A: Your indwelling nasal implant can be removed at any time. The question is not whether it can be removed but whether to do anything else to replace it at the time of its removal. Taking the implant out will deflate the nose so it will get flatter and shorter, perhaps close to what you were before. Certainly that is the easiest option but perhaps not the most esthetic. Replacing it with a rib cartilage graft is the most aesthetic but not the easiest. Intermediate options include placing layers of allogeneic dermis (e.g., alloderm) on the dorsum and a septal columellar strut graft. That would be a good revisional rhinoplasty compromise as it would produce an intermediate aesthetic result without the need for rib graft harvesting. I suspect you really won’t like the appearance of the nose when the implant is removed but may not really want to have a rib graft harvested either.
Dr. Barry Eppley