Silicone implant heals by encapsulation. It is being treated as a foreign body so the natural reaction of the body is to form a capsule around it. This is a very loose attachment of the implant and any medium velocity force exerted around the nasal area can result in implant malposition and deviation.

Contracture formation and migration of the implant

Some patient’s don’t develop immediate reaction with the implant and has satisfactory cosmetic results during the first years. However, because of the force exerted by the hard silastic silicone implant on the nasal tip it results in pressure necrosis and eventual migration of the implant upwards (pig nose look)

Severe Contracture Formation

If the implant was not immediately removed, it may result into severe contracture formation with irregularities and scar like tissues on the nasal bridge. Cases like this are very difficult to treat and needed grafting procedures to look cosmetically acceptable.

Implant extrusion

Implant extrusion (red arrow) is a common problem encountered after silicone rhinoplasty. The implant erodes the soft tissues of least resistance and in this case – the incision line. This line maybe unilateral or bilateral depending upon the surgeon’s preference. Treatment should be immediate removal of the implant since antibiotics are not expected to penetrate through the capsule formed around the silicone.

Destruction of the Columella

The middle portion of the nose ( in between the nasal alae) is very prone to scarification which can lead to a permanent deformity. Non treatment of an infected silicone implant will result in this condition

Sometimes even after the implant has already been removed, some residual tissues (red arrow) develop crevice like scars on the nasal tip and bridge. Skin grafting techniques are preferred to remedy given condition.

A silicone implant achored deep into the septal spine may cause erosion of the premaxilla (palate bone). This condition can result into food and saliva going into the nasal cavity and eventual aspiration

20 years after a Silicone noselift

Other patients augmented with a silicone implant are clearly asymptomatic for many years. However there is growing evidence nowadays on the deposition of calcium crystals on a prolonged implant (red arrow). The crystals causes nasal bridge irregularity and in one study (Kim et.al) shows evidence to be pre-carcinogenic, suggesting to change the implant every 20 years – similar to breast cohesive gel implants.

Hundreds of silicone implants already removed in this clinic and replaced with GORE-TEX implant

(Click on the left image to enlarge)

Why silicone implants don’t work- can be explained by this simple diagram that shows the nasal anatomy. Our nose have 2 joints, one connecting the cartilage with the bone and the other one connecting the alar cartilage with the upper cartilage. These joints allow free movement of the nose from left to right, upwards and downwards. If we place a hard silastic silicone implant above these structures, the joints will be fixed and any medium velocity force to the nasal area can lead to resulting trauma (similar to placing a nail over the nose)

An alternative implant is the GORE-TEX material which is porous and allow tissues to grow into and around it treating it not as a foreign body but part of yourself. It has originally been used for heart and pulmonary bypass operation since 1953 and was found to be the best material for augmentation purposes. The technique involves 2 or 3 layers of the gore-tex sheet placed over each other and the edges tangentially curved. We imitate the natural contour of the nose providing a double break point at the nasal tip with the use of conchal or septal cartilage to preserve the nasal joints and allow you to maintain normal physical activities and contact sports

- Cosmetic Surgery is to become beautiful
- If it is not safe then there is no point
- BEAUTY AND SAFETY SHOULD BE OUR PROMISE