Allopastic implant is commonly used for dorsum augmentation in Asian countries. This is removed for various reasons; deviation, extrusion, foreign body reaction, and inflammation. When the allopastic implant needs removal, there are 3 options for the patient.
First, just remove the implant and wait. Further surgery on the nose is planned after all complications subsided. The best time is at least 6 months after surgery. This is a freqeuent option when alloplst was implanted within 1 year without any further manipulation of the dorsum and the tip.
Second, implant is removed and restoration of the nose to the preoperative status is done at the same time. Nasal hump removal, rasping of the dorsum for implant fitting, implantation years earlier, other manipulation of the dorsum and the tip needs additional maneuver to make the dorsum and tip look normal after implant removal. Commonly, remaining septal or conchal cartilage, periosteum, or fascia is used for this purpose.
Third, when patients love the current shape although implant needs removal due to complications, the volume of the implant needs to be filled with autogenous materials. Or when the patients want further improvement of the nose, various autogenous materials are neccessary including rib cartilage. Sometimes, using rib cartilage is the only option to satisfy this kind of patient.
Choosing among the above 3 options depends on the patient's wish, current nasal status, availability of the autogenous material, and surgeon's experience level.
First, just remove the implant and wait. Further surgery on the nose is planned after all complications subsided. The best time is at least 6 months after surgery. This is a freqeuent option when alloplst was implanted within 1 year without any further manipulation of the dorsum and the tip.
Second, implant is removed and restoration of the nose to the preoperative status is done at the same time. Nasal hump removal, rasping of the dorsum for implant fitting, implantation years earlier, other manipulation of the dorsum and the tip needs additional maneuver to make the dorsum and tip look normal after implant removal. Commonly, remaining septal or conchal cartilage, periosteum, or fascia is used for this purpose.
Third, when patients love the current shape although implant needs removal due to complications, the volume of the implant needs to be filled with autogenous materials. Or when the patients want further improvement of the nose, various autogenous materials are neccessary including rib cartilage. Sometimes, using rib cartilage is the only option to satisfy this kind of patient.
Choosing among the above 3 options depends on the patient's wish, current nasal status, availability of the autogenous material, and surgeon's experience level.
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