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Rhinoplasty Revision After 30 Years: Resolving Silicone Extrusion and Chronic Rhinitis

noselab

[Nose Lab Clinic]


Hello, this is Dr. Cha-Young Kang, Director of Nose Lab Clinic.


Today, I’m sharing a complex revision rhinoplasty case involving a patient who experienced silicone extrusion and chronic rhinitis after undergoing nose surgery 30 years ago. This case demonstrates how we addressed both aesthetic and functional concerns to achieve a natural, balanced, and functional outcome.

Design Consultation: Frontal View, Left Side View, and Oblique Side View Photos


1. Surgical History


  • 30 Years Ago (Korea): L-shaped silicone implant insertion.

  • 20 Years Ago (Japan): Suspected revision using silicone.

Design Consultation: Right Side View, Oblique Side View, and Nostril View Photos


2. Main Symptoms


  • Visible silicone extrusion at the nasal tip.

  • Severe nasal discharge.

  • Frequent sneezing.

  • Chronic rhinitis symptoms.


3. Patient’s Goals


  • Eliminate silicone extrusion.

  • Resolve chronic rhinitis symptoms.

  • Achieve a natural and aesthetically pleasing nose line.

  • Accept a rounded tip if necessary for a natural look.


4. Surgical Approach


a. Addressing Existing Issues

  • Complete removal of the old silicone implant.

  • Reconstruction of damaged cartilage.

  • Surgical treatment of rhinitis to alleviate symptoms.


b. Functional Improvement

  • Nasolabial angle correction.

  • Reconstruction of the deviated nasal septum.

  • Restoration of normal breathing function.


c. Aesthetic Refinement

  • Formation of a natural nasal tip.

  • Overall balance adjustment of the nasal structure.

  • Establishing a stable nasal framework.


5. Surgical Results

Before (Left) / Immediately After (Right)


a. Frontal View

  • Resolution of silicone extrusion.

  • Natural, balanced nasal tip shape.

  • Harmonized overall nasal contour.

Before (Left) / Immediately After (Right)


b. Side View

  • Improved nasolabial angle.

  • Softer, smoother tip line.

  • A harmonious profile that complements the facial structure.

Before (Left) / Immediately After (Right)


c. Oblique View

  • Enhanced 3D contour and natural projection.

  • Stable structural support.

  • Improved overall balance.

Before (Left) / Immediately After (Right)


d. Nostril View

  • Correction of nostril asymmetry.

  • Straightened columella, previously tilted to the left.

  • Removal of scar tissue visible on the left columella.


e. Functional Improvement

  • Significant reduction in rhinitis symptoms.

  • Improved breathing.

  • Reduced nasal discharge and sneezing.


6. Expert Commentary

Immediately After Surgery: Frontal, Oblique Side, and Side View Photos











Immediately After Surgery: Nostril View Photos


Long-term silicone implants often lead to complications such as extrusion, tissue thinning, and infection. In this case, the challenges were compounded by the need to address both aesthetic deformities and chronic rhinitis.


Key steps included:

  • Safe removal of the aged silicone implant.

  • Meticulous reconstruction of damaged structures using autologous tissue.

  • Functional improvements through septoplasty and rhinitis treatment.


The final outcome achieved a natural and balanced appearance while significantly improving the patient’s quality of life.


At Nose Lab Clinic, we approach every case with a commitment to safety, functionality, and aesthetic excellence.


Dr. Cha-Young Kang

Director, Nose Lab Clinic

Thank you.



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