No abstract

Silicone implant is known to be safe and easy to handle, and frequently used in Asian rhinoplasty. Compared with breast implant, complication studies about silicone calcification used in rhinoplasty are very limited. Recently, the authors experienced an interesting patient who underwent revision rhinoplasty in our institution. Based on preoperative images, previously inserted dorsal augmentation material was identified. It was circumferentially enclosed with bony material and hypertrophied bony lesion induced hump on the mid portion of nasal dorsum. During operation, the authors found it was the calcified capsule of silicone implant, and the calcification was surrounding the whole implant material.

Augmentation rhinoplasty using alloplastic materials is a relatively standard procedure in Asian patients. Expanded polytetrafluoroethylene (ePTFE) is one of the commonly used alloplastic materials because it has a high biocompatibility and is easy to handle. Recently, a patient who had previously undergone augmentation rhinoplasty using ePTFE as the implant material visited our clinic. She had the implant material surgically removed after three years and visited our clinic with a nasal dorsal hump. The patient underwent revision rhinoplasty at our institution. Unexpectedly, we found some ePTFE material that was not identified on the preoperative X-rays. After removing the ePTFE material, the nasal dorsal hump was corrected, and we did not need to perform a nasal dorsal hump reduction.

Use of an oscillating-blade saw equipped with a scalable guide facilitated quantitative mandibular angle ostectomy, enabling precise, and reproducible surgery with satisfactory outcomes with less complications.