LAM FACIAL PLASTICS

I had an L silicone implant put in my nose 6 months
ago.

I have had no issues with it so far. However, I
heard from one doctor that all silicone L implants
will extrude within 15 years. Is this true? How high
is the risk of extrusion?
Also, is it true that L implants make your nose more
bulbous?... because I feel that after I had the
implant added, my nose has become bulkier.

Finally, if I were to remove this implant, how much
would it cost to repair my nose tip cartilage and
remove the implant?
Also, how much would it cost to have a revision with
goretex sheets?

Hi,
Yes, there is a higher rate of extrusion with silicone implants. In fact, that is one of the reasons why I have stopped using them. I noticed quite a few of my implants coming out after months to years.

That being said, I would not panic. I have worked with surgeons who have successfully had silicone nasal implants stay in years and years without any problems. Silicone will not automatically extrude. I have also noticed that a high percentage of my patients did not have a problem with their silicone nasal implants from years past.

The other reasons that silicone may become an issue over time is that it can look a bit shrink wrapped and can look too high even with slim profile solid implants. In that case, switching it out for a slimmer profile and softer Gore-Tex sheeted implant may be a good option.

As far as making your nasal tip look more bulbous, that depends on what kind of implant you had. Almost any material can make your tip look bulbous if the implant is too large, if there is still some swellling that is present, or some scar tissue has developed.

If you just want the implant removed, I charge $1000 and can be done in the office setting with really no discomfort. If you do a revision the cost is about $7500 including anesthesia and facility charges. Obviously, these prices are subject to change with cost increases specifically with increasing facility charges over time. However, I do not expect any immediate changes in cost in the near future. Btw, you do not pay for the implant removal if it is done at the same time as the change over to Gore-Tex and cartilage tip graft.

Hope that helps,
SML

Hi Dr. Lam,

Thank you so much for your response!

I have a few more questions I want to address before making a decision.

Is it far fetched to think that an L silicone can last for a lifetime without the need for replacement?
If I decide to remove the L implant but not replace it with goretex, would I need to repair the tip cartilage as the strut is placed in between? If I don't repair this cartilage, would my nose look wider than before as a result?
I have heard that goretex cannot render as slim of a nose as silicone. Is this true?

1. silicone implants can last a lifetime. i have personally seen people with a good looking silicone implant 30 years after implantation.
2. gore-tex can be less "pointy" and sharp on the bridge but I think that is a good thing. I don't like the sharp borders that silicone implants make on the nose profile.
3. if i remove the silicone sometimes the scar tissue that has formed can maintain the bridge height. i can finesse that with silicone injections. that would be an extra charge of $700 per treatment as needed. oftentimes your tip is fine and does not need further work.
hope that helps.
best,
sml

Thank you Dr. Lam.

For now, I think I will keep the L implant as it has not caused any complications.

If I do need to do something about it in the future, you can bet that I will come to you. I have heard many wonderful things about you, and your forum has really touched me!

Thanks. don't worry. I think your nose will be fine. Hopefully, you will not need my services. Look out I will be starting a real blog in 1 to 2 days!
best,
sml