Revision Rhinoplasty in Noses Previously Treated with Silicone or Fillers – Risks and the Process

Having previously had fillers (hyaluronic acid, permanent fillers, fibrocell), silicone implants, Medpor, or other foreign materials applied to the nose directly affects the surgeon’s approach during revision rhinoplasty.

Revision rhinoplasty is possible; however, each case requires individualized planning.

Do Silicone / Permanent Implants Carry A Higher Risk For Revision?

Yes, because:

• They may cause a tissue reaction
• The risk of infection may increase
• They may lead to thinning of the surrounding tissues
• Irregularities may develop in the skin and cartilage structure

For this reason, during revision the surgeon should remove the implant completely and reconstruct the nasal framework.

What Is The Situation In Noses That Have Had Fillers?

Temporary fillers (hyaluronic acid):

•  They are generally the easiest group to revise.
•  They are dissolved with a special enzyme (hyaluronidase) before surgery.
•  The tissues are made suitable for surgery.

Permanent fillers (methacrylate, silicone-based fillers):

•  They may be difficult to remove because they can spread within the tissue.
•  They may cause surface irregularities or an inflammatory process.
•  Revision surgery requires more detailed planning.

Does The Need For Additional Cartilage Increase During Revision?

Most of the time, yes, because:

•  Permanent materials weaken nasal support.
•  Structural repair is needed due to tissue damage.

For this reason, support can be provided using rib, ear, or septal cartilage.

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