Should My Nasal Implant Be Removed And Replaced?

Q: Dr. Eppley, I have a silicone implant to build up the bridge of my nose for years. I have a few questions for you about it based on your expertise in rhinoplasty, Your feedback is extremely helpful.  My skin is thin and I have a medium size implant in my bridge area. ] Do you think that I should be concerned about extrusion?  If this starts to extrude later on do you think the area can be filled with fat?  I’ve never seen a photo of someone with a medium sized implant removed so I have no idea how deformed it looks.  I’ve also heard that revision tip surgery is more difficult with the implant  due to the increased chance of infection and hardening of the tip?  I’ve also heard that it can take up to 10 years for infection of an implant to show up?  Thank you

A: The long-term effects of a silicone implant on the nose depend on several factors including the size and shape of the implant, the thickness of the nasal tissue and how long it has been in place. Many nasal implants when removed after long-term placement will leave the nose looking ‘deformed’ due to the expanded skin over a now smaller underlying framework. While fat could be used to replace a silicone implant, it is not as predictable in terms of survival and smoothness of shape as a cartilage graft replacement. Whether you should remove or keep your nasal implant is impossible for me to say since I don’t know what you look like now and how the bridge of the nose looks and feels. Signs of ominous problems with your imlpant include skin color changes, visible edges of the implant or swelling and redness over the nose. It is understandably hard to get enthusiastic about replacing a nasal implant when it is asymptomatic.

Dr. Barry Eppley

Indianapolis, Indiana