Hello, this is Dr. Chayoung Kang, Director of Noselab Rhinoplasty Clinic. Today we will introduce a case of a serious rhinoplasty complication. This patient visited our clinic due to a silicone implant rupture through her nose tip.
Cases like this one are emergency situations that require immediate action, and expert treatment is of great importance.
Preoperative Design Consultation
Patient’s Medical History
- 20 years ago: Nose filler
- 13 years ago: Rhinoplasty using a silicone implant and ear cartilage.
- Present: Came to the clinic to correct an upturned and deviated nose.
- Upturned nose tip crushed to the left side
- Typical nasal contracture deformation
- The nose became unnaturally high due to the swollen tissue surrounding the nose bridge implant.
- Noticeable nostril asymmetry
- The silicone implant was visible exposed from the left nostril.
- Unnaturally high nose bridge
- Noticeably upturned nose tip
- Prominent nasal deviation and contracture deformation
- The contour of the silicone implant could be seen through the skin.
- The silicone implant ruptured through the left nostril.
- Severe nostril asymmetry
Additional Examination Results
- Through the CT sagittal plane, the silicone implant was found to be pushing through and down towards the nose tip.
- Direct confirmation that the silicon implant had ruptured through the left nostril.
Diagnosis: Acute inflammation and nasal contracture deformation caused by the silicone implant.
Treatment Plan
a) Emergency attention
- Removal of the silicone implant
- Desinfection and cleansing of the infected area.
- Removal of the contracture and inflammation tissue.
- Suture of the are where the silicone implanty had poked through.
b) Medication treatement
- Antibiotic injections treatment (for 5 days)
- Oral antibiotics prescription (for 10 days)
c) Additional treatment
- Hyperbaric oxygen treatment
- Stem cell injection treatment
- Helium laser treatment
d) Future plans
- After the contracture tissue has stabilized, we plan to perform a rhinoplasty using autologous rib cartilage.
Treatment and Surgical Details
a) Surgery to remove the silicone implant
- Silicone implant safely removed though the closed rhinoplasty approach.
- Removal of the surrounding granulation and contracture tissue.
- Desinfection and cleansing of the infected area.
- Suture of the area ruptured by the implant.
b) Stem cell therapy:
- Stem cells extracted from autologous fat and injected around the nose.
- This is expected to help with tissue regeneration and reducing inflammation.
c) Antibiotic treatment:
- Request for bacterial culture and antibiotic susceptibility testing of the purulent discharge.
- Selection of appropriate antibiotics and injection treatment administration for 5 days.
- Once the antibiotic susceptibility test results were available, we changed to the optimal antibiotic and administration of injection treatment for 7 days.
- Prescription of oral antibiotics for 10 days.
d) Additional treatment
- Hyperbaric oxygen therapy: Helps promote healing and reduce inflammation by increasing oxygen supply to tissues.
- Helium laser treatment: Helps reduce inflammation and promote tissue regeneration.
Overview – implant rupture
This case is a good example of the long-term complications of rhinoplasty surgery and their severity. Silicone implant rupture is a very dangerous situation and requires immediate action. In this patient’s case, we avoided the risk with the prompt removal of the implants and appropriate follow-up treatment.
The risk of silicone implants pushing down towards the tip of the nose increases when repeated foreign body reactions to the bridge of the nose occur without proper treatment. In particular, it is common for silicone implants to be inserted up until the nose tip. Therefore, it is sufficiently preventable by making the tip of the nose with strong cartilage and using short silicone implants only on the bridge of the nose.
In particular, it is important to note the importance of the comprehensive treatment approach when these complications occur. In addition to surgical treatment,
we combined various methods such as antibiotic treatment, stem cell treatment, hyperbaric oxygen treatment, and helium laser treatment to achieve the best results. This approach was possible because of Noselab’s extensive knowledge and experience as an otolaryngologist.
Currently, the acute inflammatory response is being controlled and the structural deformation is being minimized. In the future, it is expected that the condition of the tissues would improve by the stem cell treatment. When the tissues have stabilized, we plan to perform rhinoplasty using self-rib cartilage.
With Noselab Rhinoplasty Clinic you can achieve a beautiful and healthy nose.
Thank you.
Noselab Rhinoplasty Clinic
Dr. Chayoung Kang.
https://blog.naver.com/cykang/223526709528
https://noselabps.co.kr/category/before-after/contracted-complicated-nose
