Today, I had to do an unfortunate revision nose job that I believe could have been prevented. Some nose jobs, also referred to as rhinoplasties, require that the profile or bridge of the nose be built up in order to help the nose fit the face. This is commonly the case in ethnic nose jobs including African American and Asian patients. There are natural procedures and implants that can be done to build the nasal profile.
Natural options include using your body’s own cartilage and tissue. Depending on the patient, the cartilage can be taken from the nose, ear, or even rib. In most cases, I always try to use the nose cartilage if there is a large amount in the body. I will only use the ear or rib as a back-up. Tissue can be taken from a hidden area either in the scalp or near the rib.
Some cosmetic surgeons use implants made of silicone or Gore-Tex in the nose. These implants have been used safely in other areas of the body including the breast and chin. They can be carved to give a nice shape to the nose.
Back to the question at hand: Why don’t I use nasal implants?
The nose has very unique qualities, and I do not believe that an implant is a good option for the nose. The nose skin is very thin compared to other areas of the body. There is a risk that the pressure of the implant on the thin skin can cause the implant to injure the skin.
When compared to natural tissue, an implant has a much higher rate of infection. If the implant gets infected, it is also harder to treat than natural tissue. An infected implant can actually cause the skin of the nose to die and the nasal implant may then be exposed. These increased risks of an implant in the nose are the main reason I use the natural cartilage of the body to build the profile of the nose.
Today’s unfortunate case was a revision rhinoplasty of a Hispanic patient that had a silicone nasal implant placed in the nose. I had to remove the implant to clear the infection. The patient will be on antibiotics for weeks. This will be a difficult time for the patient as there will be an obvious deformity to the nose.
After the infection clears, the patient will undergo another revision rhinoplasty to repair the nose. During this procedure, we will be using the patient’s own natural tissue.