LAM FACIAL PLASTICS

Dear dr Lam,

I'm 25 year old asian woman, and I just had open rhinoplasty almost one week ago. I had silicone implant for the bridge, and ear cartilage for the tip. The doctor took my cast off 2 days after surgery, and so far my nose looks good. Still swollen, but good. I have been putting on this cream, called Arnica, supposedly help with the swelling and bruises. I put the cream ON the nose and area around the nose. My question is:

1. Is it okay to touch and put cream on the nose 3 days after rhinoplasty using silicone? The thing is, I heard that silicone implant tends to shift easily.

2. How easy for the silicone to shift or move place? I've become so paranoid of doing any activities because I'm too scared I might move the silicone!

3. I've been told to sleep lie straight on my back, don't sleep facing to the sides. How long do I have to sleep like this? And does sleeping face to the side can cause the implant to move position?

4. When can I start to do my normal activities? And when can I start to put on makeup on nose?

5. I heard about silicone implant can move downwards over time. What should I do to prevent that happening?

6. A friend of mine had nosejob with silicone, and months after the surgery, she made out with boyfriend, and due to passionate kissing, the nose implant became crooked. I'm so terrified this might happen to me. Does it mean I will never be able to "kiss passionately" again for all my life?

Please please explain, dr Lam. Your answer would help a lot! Thankyou.

Another question :

You said " have had enough problems with silicone that i have abandoned its use in the nose altogether. it is great for chin implants but really not for nose implants."

Please explain what kinds of problems might arise regarding to silicone implant? The thing is, in my country Indonesia, all doctors seem to use silicone. They never use Gortex apparently, and Gortex isn't even available. Why is this?

Thankyou again.

What I've seen was silicone is over time it can encapsulate where you can see the edges of the implant. In addition, what I've noticed is that the implant due to the weight can actually shift downward and cause pressure on the nasal tip. The problem with this is that they can create an unnatural looking tip and also problems with the nasal tip in terms of contraction. This can lead to a foreshortened nasal tip which is very hard to fix. it occurs unfortunately in some cases. this type of problem is on the less common side.

The problem with finding gore-tex in your country I am not aware of. I know it is something that is probably harder to find and is more expensive to obtain and certainly harder to insert than a silicone implant. This could be the reason why.