Dr. Sam Lam Plastic Surgery Forum

Hi Dr. Lam,

I know of a person who had an L implant when they were 16. Now after 4-5 years, their nose is bulbous as the silicone has pushed the cartilage wider.
Is this a common issue with L silicone implant? Have you seen an L silicone implant make a nose wider at the tip over time?

Thank you.

This is quite uncommon but possible. If the nasal implant is quite large relative to the size of the tip cartilage, I have seen the implant apply pressure to the tip and cause either the cartilage to erode, i.e., be partially lost or splay from the pressure. The other reason for the thickening could be scar tissue development around the implant which usually occurs earlier than later. The most common cause though is that the implant slipped downward and is causing the tip to be bigger. If that is the case, the implant should be removed sooner than later, as it can cause undue pressure on the nasal tip skin and even herniate through the skin over time. It is best to seek professional assistance from someone who has experience in dealing with Asian rhinoplasty to make that call, preferably through an in-person consultation.

That is why I perform what in Asia is known as a two-piece augmentation, i.e., Gore-Tex to the bridge and one's own cartilage to the tip.
best,
sml