LAM FACIAL PLASTICS

by **buki3** » Wed Feb 09, 2011 9:06 am

Hi Dr Lam, I am a 25 year old asian male. I have just ungergo a nose implant surgery a month ago. i am very unhappy with the result because even tho my nose is more define, to me it looks too unnatural. My nostrils is also not proportion with the other, they seem to have a different roundest in shape. I have also learned that implants tents to shift in time and i do not want to spend my life doing corrective surgery. My question is..can nose implants be removed? if it can would my nose go back to its nature shape?..is there another alternative procedures that could achieve that natural define asian nose i was after in the first place without a solid looking implant put inside me? Please help!

by **dr. lam** » Wed Feb 09, 2011 12:34 pm

it depends on what kind of implant it is. if it is silicone it is easily removable. if it is gore-tex it is removable with a little work. if it is med-por then it is near impossible to remove without doing a big surgery and there can be damage to the local tissue afterward. besides a solid implant you can go with injectable products. however, for permanent injectables i do not like to inject a lot just a little because i would like the product to age well for you. fortunately, sometimes the scar that develops around silicone can lead to some retention of the bridge after the implant is removed so you might need very little injectable product to restore it to the same or similar result.
best,
sml

by **buki3** » Wed Feb 09, 2011 9:17 pm

Thank you Thank you Dr lam for replying to me so quickly. I feel like there is hope for me now. I only had the implant a month ago, how long do i have to wait to be able to remove the implant? Is the procedure to remove the implant risky or dangerous at all? Are u confident is is a procedure that will go well for me? Sorry for all the questions, im just a little stress about it right now but your answer have made me feel a lot better.

Thank you so much again, hope to hear from u again soon

by **dr. lam** » Wed Feb 09, 2011 10:46 pm

again, i would need to know what kind of implant you have. if it is silicone it should not be too risky.

by **buki3** » Sat Feb 12, 2011 6:22 am

Hello again Dr Lam,
Yes it is a silicone implant. I glad to know it is low risk and easily removal. I only had the implant put in 1 and half months ago, how long do i have to wait before i can get it removed? or is it something i get done now? What exactly are injectable?

Hope to hear from u soon, thank you so much for your time.

by **dr. lam** » Sat Feb 12, 2011 7:43 am

yes, you can remove it anytime. i would recommend removing it sooner than later. if you wait a year or two the cartilage underneath can have pressure problems and become literally crushed by the implant over time if it is a larger implant. it is not an emergency to remove it but if you plan to remove it i probably would not wait a year or two. as far as the injectables are concerned, if we are just talking about the bridge and not the tip then you can inject small amounts of silicone but that takes a couple of rounds plus it cannot be done at the same time as the implant removal but done a few months later and cannot be done to raise the bridge very much. the tip needs a cartilage graft for augmentation since injectables simply do not work in the tip very well.

by **buki3** » Tue Feb 15, 2011 11:58 pm

Hello again Dr Lam,
I wanted to get prices on how much it will cost if i just wanted to preform a straight removal of the implant by you. It it safe to say that my nose will just go back to its original appearances? I live in Australia. What number or email would i have to contact to receive more info and a rough quote?

by **dr. lam** » Wed Feb 16, 2011 7:47 am

there is no guarantee that it will go back to exactly the way it was. the implant can change the cartilages underneath over the long term and also some scar tissue can develop under the skin. generally, with the shorter amount of time you have had this in it should not be a big change i do not believe. you can email me at samlammd@yahoo.com and i will forward your request to my staff to help with coordination.
best,
sml

by **candice** » Sat Jun 30, 2012 2:41 am

how did u go with the removal and did u need fillers after?
I am also from Ausrealia and have the same problem

it's only been 1 week and im feeling very stressed and depressed.. I really want to remove mine ASAP as it is obviously crooked and way too big and out of proportion for my face, very unnatural looking

by **dr. lam** » Sat Jun 30, 2012 7:44 am

if you are one week out, you probably will be fine but speak with your surgeon and express to him your concerns.
s.

by **candice** » Sat Jun 30, 2012 7:01 pm

Dr Lam, i didn't expect you to reply my post, I'm surprised you did so quickly and the amount of dedication you have towards helping everyone is immense, which gives me such a great feeling that I have coincidentally came across your forum. I do have a few questions for you which I hope you can answer.

The first rhinoplasty I had was 5 years ago, it was slightly crooked to the same side but not as noticeable.
1 week ago I decided to finally fix the problem but unfortunately things did not turn out well for me. It is even more noticeably crooked now and I really want to remove this L shaped implant as I can feel the top part of it being pushed up towards my left brow, my surgeon has told me to wait for the swelling to go down when clearly it is not because of the swelling, you can actually see and feel the implant being slanted to the left.

Could there be a problem with my nose structure which keeps causing my implants to deviate in that direction?

Secondly is it possible to have this removed even after 1 week? I am stressed, have missed out on important events and will continue to until this problem is fixed

Lastly, I am contemplating whether I should get fillers after, just so I have a temporary bridge (i prefer the more subtle look anyways) until I find the right surgeon to correct my nose with surgery, would you recommend these fillers and how long after the removal can I have it done?

I have read a lot about you since I've found this page and am hoping you can help me solve my problems and perform the final job for me as I am a little scared and nervous after two surgeries that went wrong.

Regards,
Candice

by **dr. lam** » Sat Jun 30, 2012 7:20 pm

hi,
thanks for the kind words. obviously, i don't know your situation perfectly so i can't give you direct advice. however, in general, sometimes things are hard to get perfectly straight but it could be due to the way the nose is shaped or that the pocket was not made perfectly or the previous pocket prevented the implant from going in as straight as possible. nevertheless, in my opinion it is safe to remove the implant early and in fact sometimes safer than many years later because silicone implants can cause pressure changes to the underlying cartilage. now, if you had a silicone implant years ago that was recently removed and replaced with the new one, the risk is that the new implant could be masking the damage to the cartilage from the previous one. that is something you can discuss with your surgeon. in general, i am not a big fan of using fillers if you are planning on a revision surgery for two reasons: 1) it can compromise blood supply for another surgical procedure and make the next surgery more precarious. 2) the filler can linger in there for years sometimes and it is hard to know if it is gone or not when doing a formal surgical revision.
best,
s.

by **candice** » Sun Jul 01, 2012 5:16 pm

Thanks again for your advice Dr Lam
Is it too soon to have a revision since it has only been 1 week and a few days?
How much is the estimated cost u will charge for this kind of operation?

by **dr. lam** » Sun Jul 01, 2012 5:26 pm

revision is difficult at this point because there will be a lot of swelling and it would be hard to read what is going on. personally, speak with your physician. if it really bothers you, then personally i would have it removed and plan for a revision in several months but again this is a very hard thing to communicate since i have no idea what you have in there, what you had before, and the risk of contracture of the tissues upward if the implant is left out a long time. because of the complexity of this situation, you might want to seek an local provider instead of myself. unfortunately, i do not post pricing on here. you can email my office constanze@lamfacialplastics.com for a quote on a revision nose that would probably take 2.5 hours to perform.

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