Dr. Sam Lam Plastic Surgery Forum

Hi Dr. Lam, I am a 24-year-old Chinese female. In October 2008, I had Rhinoplasty with I-shaped silicone implant, ear cartilage to the tip, and alarplasty. The first implant was shifted and too high, so I replaced it with a smaller implant in November 2008. I didn't like the way the second implant looked either, so in early January 2009 I decided to remove the implant (and left the ear cartilage in). Therefore, i have already had two revisions.

It's been about 10 weeks since I have removed the silicone implant, but my bridge is still not back to its pre-op state. I don't like the way my current bridge looks. It is still wider and taller than my pre-op nose. The bridge looks kind of blobby, with no definition. Is this due to scar tissue or swelling? If it is due to scar tissue, does that mean it will stay that way permanently? Is there anything I can do to get my bridge to go back to the way it was pre-op? For example, massaging to loosen up the scar tissue, taping, or another revision?

Another problem is that my nose looks a little bit overprojected, since I took the silicone implant out and left the ear cartilage graft in. WIll the ear cartilage re-sorb and lose some projection over time?

Thank you so much for you time.

all hard to say since i don't know your situation. some could be swelling, and taping could theoretically help. some scar tissue could be brought down with 5-FU injections but not the scar tissue that served as an encapsulation around the implant. that will remain. if you do that, i don't think it would be a good idea because the tip will then look even bigger. you don't want that. as far as cartilage resorbing, that is hard to say. sometimes yes, sometimes no.
best,
sml

Thanks for the response, Dr. Lam. It's discouraging to know that what I have is likely scar tissue from the encapsulation of the implant and will remain. I am still crossing my fingers and hoping that I will see some changes over time.

Would you recommend a revision? I'd like to remove the scar tissue if possible, and take out the cartilage graft. I regret having surgery, and just want to go back to my old nose.

i would have to see your case but sometimes you can't go all the way back. start trying to focus on the future. i can help you with the nose after 6 months of at least waiting for the swelling to go down.
love/respect,
sml