LAM FACIAL PLASTICS

Hi Dr. Lam,

If a person has an L silicone implant for 15-20 years, and wants to remove it because of either protrusion signs or deviation, what are the chances of the L having eroded the cartilage tip?

In my belief, L silicone generally does not deform the nose upon removal, even after a long period of being encapsulated within the nose. Is this true? Or, rather, does the L silicone deform noses often upon removal, especially when it has been in the nose for a long time?

Thanks!

Unfortunately, I have oftentimes encountered pressure necrosis on cartilage upon removing a silicone implant as well as pressure changes on bone. This is dependent on multiple factors but principally on the size and heaviness of the implant itself.

I don't want to scare you. In general, my recommendation is that if the implant looks bad, it should be removed. If there is pressure changes, in general, I can fix it with a few drops of liquid silicone if need be. Of course, a revision rhinoplasty may be necessary. However, silicone implants usually are so big especially with the component of encapsulation that simple removal is sufficient in many cases if not better. Obviously, only an inperson consultation would be necessary to make those decisions with you.
best,
sml

Hi Dr. Lam,

Could you approximate or guess how many patients who receive a silicone L implant get pressure necrosis on the cartilage? Also, about what percent of your patients need more than simple removal of the implant?

Thank you.

Hi Dr. Lam,

Cartilage necrosis is when the skin retracts or shrinks?

However, I was also wondering if after a duration of time the silicone can erode the nose tip cartilage to the point that it is apparent upon removal of the implant.

I would really like to know about what percentage of patients require revision surgery upon removal of the implant because of necrosis, and erosion.

I've been very worried about the longterm effects of having silicone. Thank you for your truthful responses.

sorry for the big words: necrosis means partial cartilage loss. i would say the minority need to have revision since most silicone implants are just too big. so after removal the nose can be about right. however, sometimes silicone touchups are necessary if there is necrosis or if the nose tip is too "weak" and the bridge too low, then a revision rhinoplasty may be needed.