[Nose Lab Clinic]
Hello, this is Dr. Cha-Young Kang, Director of Nose Lab Clinic.
Today, I’m sharing a revision rhinoplasty case involving the removal of a Silitex implant (a combination of Gore-Tex and silicone) that was initially mistaken for a Gore-Tex-only implant. The patient underwent reconstruction to address functional and aesthetic concerns, achieving natural and balanced results.
Design Consultation: Frontal View, Left Side View, and Oblique Side View Photos
1. Surgical History
2019: Primary rhinoplasty using a Silitex implant (Gore-Tex encased silicone).
2. Initial Assessment
Design Consultation: Right Side View, Oblique Side View, and Nostril View Photos
a. Frontal View:
Excessive nostril exposure.
Implant translucency visible on the nasal dorsum.
High starting point of the nasal bridge.
Long philtrum.
Overall artificial and disproportionate appearance.
b. Side View:
Overly high nasal root at the glabella.
Short, upturned nasal tip.
Depressed columella.
Narrow nasolabial angle causing the appearance of a protruding upper lip.
c. Oblique View:
Prominent upper lip protrusion.
Unnatural transition from the glabella to the nasal dorsum.
Columellar retraction.
d. Nostril View:
Significant asymmetry between nostrils.
Noticeable scar tissue on the right columella.
3. Patient’s Goals
Reference Images Desired by the Patient
Correct the nasolabial angle to reduce lip protrusion.
Lower the starting point of the nasal bridge.
Achieve a natural-looking transition at the nasal root.
Create a sharp and defined nasal tip.
Minimize nostril visibility.
Lower and refine the columella for better support and balance.
Reference Images Desired by the Patient
4. Surgical Approach
a. Implant Removal:
Safe and complete removal of the Silitex implant, including adherent Gore-Tex layers.
Thorough excision of residual scar tissue and damaged soft tissue.
b. Structural Reconstruction:
Nasal Tip: Autologous rib cartilage used for tip projection and support.
Nasal Dorsum: Silicone implant customized to achieve a natural, smooth dorsal line.
Columella and Nasolabial Angle: Rib cartilage grafts to improve the nasolabial angle and reduce lip protrusion.
c. Overall Refinements:
Facial fat grafting for harmonizing contour irregularities.
Adjustment of the nasal root starting point for a more natural transition.
Balancing the overall nasal proportions with facial features.
5. Results
Before (Left) / Immediately After (Right)
a. Frontal View:
Balanced nostril exposure.
Elimination of implant translucency.
A natural and harmonious nasal bridge starting point.
Before (Left) / Immediately After (Right)
b. Side View:
Smooth, natural nasal root height.
Stable and well-positioned nasal tip.
Improved nasolabial angle for a more balanced profile.
Before (Left) / Immediately After (Right)
c. Oblique View:
Enhanced facial harmony with improved nasal projection and contour.
Smooth dorsal line and balanced tip projection.
Before (Left) / Immediately After (Right)
6. Expert Commentary
Immediately After Surgery: Frontal, Oblique Side, and Side View Photos
Immediately After Surgery: Nostril View Photos
This case underscores the challenges associated with Silitex implants. The Gore-Tex layer adheres strongly to soft tissue, making removal complex and requiring meticulous technique. Improper removal can leave fragments behind, potentially leading to further complications.
By safely removing the Silitex implant and reconstructing the nose with autologous rib cartilage and a silicone implant, we achieved both functional improvement and a natural, aesthetically pleasing outcome.
Key Takeaways:
Material Selection Matters: Long-term outcomes depend on using safe, biocompatible materials.
Precision Is Key: Expertise is critical for safe removal of complex implants like Silitex.
Tailored Reconstruction: Combining structural support with aesthetic balance ensures optimal results.
At Nose Lab Clinic, we prioritize safety, functionality, and natural beauty in every procedure.
Dr. Cha-Young Kang
Director, Nose Lab Clinic
Thank you.
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