LAM FACIAL PLASTICS

Dear Dr Lam,
I have a silicone implant in me for about 9 months right now. It was doing fine, I actually love everything. it's just that i see a lot of long-term complications that tend to appear months/years later, so I've decided to revise it to prevent anything like that from happening. A surgeon actually suggested a diced rib cartilage technique to recreate the same height and shape of my nose that I have now. He said he wouldnt wrap diced cartilage in fascia because the capsule is already formed in the nose. Is that true?
Will there be any more capsular contraction in the future when the silicone is taken out?
He said the diced rib cartilage technique is an excellent choice for revision cases as it prevents warping and resorption. To what extent that is true? What are the pros and cons then?
Thanks very much Dr Lam.

i think dice rib cartilage is something you really need to ask your surgeon about. of course, the pro is that it is "all natural". the con is absorption of the rib graft and possibly irregularities showing up from the diced material. since i do not perform this procedure, i do not want to give you false pros and cons of the procedure. as far as capsular contraction after removal, there is always a chance of that. however, if something is placed back in there afterward like the cartilage then that would limit the chance for further contracture.

Dear Dr Lam,
For this type of revision rhinoplasty or any revision rhinoplasty in general, would the swelling persist longer than the primary case? Would the process of swelling be the same as the first time if the first time was a closed procedure and the revised case would be an open rhinoplasty?
Thanks very much.

most likely,you will have considerably more swelling due to the technique and the fact that it is a revision. when i did silicone implants they took me 10 minutes and there was barely any swelling. now my rhinoplasties take 2 hours and they have a bit more. with the rib etc. it could take even longer and you could have more swelling but you really need to ask your surgeon these questions.

Thanks for your reply Dr Lam. I'm already at 3-to-4-month post-op now but would love to augment the nose with more of the costal cartilage. Is it too early/soon to go for it because the height of the nose won't go any higher anymore? Thanks in advance ya.

that is something you should ask your surgeon since you are early postop. i don't like answering questions of someone else's patient during the early healing times following a procedure out of respect to the surgeon who did your surgery and really to you as well.
s.