Effective Use of a Silicone-induced Capsular Flap in Secondary Asian Rhinoplasty

Abstract

Summary:Performing secondary rhinoplasty in patients who underwent primary rhinoplasty using a silicone implant is difficult due to thinning of nasal skin and formation of a capsule. Excess capsule formation can cause capsular contracture, resulting in short nose deformity or implant deviation, migration, or implant demarcation. Revision rhinoplasty using a capsular flap, dorsal silicone implant, and tip plasty was performed in 95 Korean patients (91 women and 4 men; mean age, 27 years) who previously underwent primary augmentation rhinoplasty using silicone implants. The capsular flap was composed by creating a dual plane above the anterior capsule and below the posterior capsule. The existing silicone implant was removed, and a new silicone implant was placed under the posterior capsule. The patients were followed up for 6 months to 4 years (mean, 31.7 months). Of the 95 patients who underwent secondary augmentation rhinoplasty using a capsular flap, 88 patients (92.6%) showed satisfactory results. There was no hematoma or nasal skin vascular compromise. There was no visible or palpable capsule resorption or recurrent capsular contracture. Early implant malpositioning (within 30 days postoperatively) was observed in 4 patients, and tip shape dissatisfaction (within 60 days postoperatively) was reported by 3 patients. Four patients underwent revision surgery and had successful outcomes. Nasal augmentation using a silicone implant and capsular flap in secondary rhinoplasty avoids complications caused by removal of the capsule. Recurrent capsule formation or clinically noticeable resorption of the capsular flap was not observed in this study.

Self‐organization of “fibro‐axonal” composite tissue around unmodified metallic micro‐electrodes can form a functioning interface with a peripheral nerve: A new direction for creating long‐term neural interfaces

“…The initial stage of reactive exudate formation on the material surfaces is followed by organization of the exudate into a stable capsule composed of fibroblasts and collagen fibers. [22][23][24][25] Based on our observations, we infer that the inflammatory response to the silicone and tungsten surfaces resulted in stable fibro-collagenous tissue encapsulation of the silicone tube and the micro-wires…”

Correction of a Visible Silastic Implant Using the Dual-layered Capsular Flaps

“…Augmentation rhinoplasty using an alloplastic implant is 1 of the most performed esthetic procedures in Asian countries 3,4. Among alloplastic implant materials, silastic is 1 of the most commonly used implant materials.…”

“…Augmentation rhinoplasty using an alloplastic implant is 1 of the most performed esthetic procedures in Asian countries. 3,4 Among alloplastic implant materials, silastic is 1 of the most commonly used implant materials. Silastic is a solid silicone elastomer made of repeating units of strong silicon-oxygen bonds, which provide stability.…”

Identification of transcriptomic characteristics during nasal capsular contracture progression using RNA deep sequencing

“…1 However, resulted from the simulation of silicone implant, nasal capsular contracture is a common side-effect after the rhinoplasty. 2,3 Most of the patients do not show severe symptoms, while a group of patients with excess fibrous capsular present implant deviation and short nose deformation, which can be deemed as the failure of rhinoplasty.…”