Education
Revision Rhinoplasty After a Nasal Implant or Graft Problem
Silicone, Gore-Tex and Medpor implants can shift, show or get infected. When removal is needed, and how the nose is rebuilt with your own cartilage.
ABFPRS
Facial Plastic & Reconstructive Surgery
ABOto
Otolaryngology — Head & Neck Surgery
AAFPRS
Fellowship Director
Overview
Nasal implants and grafts can sometimes become infected, visible, displaced, or poorly integrated. When that happens, revision focuses on identifying exactly what is present and rebuilding safe, durable support — often with the patient's own cartilage.
Key takeaways
- Implants and grafts can become infected, visible, displaced, resorbed, or extruded.
- Silicone, Gore-Tex, Medpor, and various cartilage grafts each behave differently.
- Evaluation may use operative reports, old photos, exam, endoscopy, and sometimes imaging.
- If a prior implant no longer provides safe support, reconstruction may use autologous cartilage.
- These cases can be complex, and staged planning is sometimes needed.
An Established Academic Authority
Double board certification. Fellowship director. Published author. A surgeon's surgeon.
ABFPRS
Board Certified
American Board of Facial Plastic & Reconstructive Surgery
ABOto
Board Certified
American Board of Otolaryngology — Head & Neck Surgery
AAFPRS
Fellowship Director
American Academy of Facial Plastic and Reconstructive Surgery
Textbook
Published Author
Contributions to the academic literature of facial plastic surgery
Dual board certification in both Facial Plastic & Reconstructive Surgery and Otolaryngology — Head & Neck Surgery.
Castle Connolly Top Doctor — Plastic Surgery, 2026Signs of an implant problem
- The implant has shifted or tilted, making the bridge look crooked
- The outline of the implant is visible, or the skin over it looks thin, shiny, or red
- The tip looks stretched, shiny, or discolored — a warning sign of skin under pressure
- Swelling, redness, tenderness, or drainage — signs of infection
- The implant can be felt moving
- Part of the implant is exposed through the skin or inside the nose (extrusion)
Redness, drainage, or skin that is thinning over the implant should be evaluated promptly.
How the common materials differ
Material What it is Typical problems Removal
--- --- --- ---
Silicone Smooth, solid implant; a capsule of scar forms around it Shifting, visibility, capsule contracture, extrusion through the tip Usually straightforward
Gore-Tex (ePTFE) Soft, slightly porous sheet Infection, which can be difficult to clear with the implant in place Moderate; tissue grows partly into it
Medpor (porous polyethylene) Rigid, highly porous; tissue grows through it Infection, visibility More involved, because tissue integrates into the material
How it's evaluated
- Previous operative reports, if available, to know exactly what was placed
- Photos from before and after the original surgery
- Examination of the skin, implant position, and signs of infection
- Nasal endoscopy
- Imaging when the implant's position or extent is unclear
Treatment
Removal. Implants that are infected, extruding, or putting the skin at risk are removed. Surrounding scar capsule may be removed as well.
Reconstruction. Once the implant is out, the nose usually needs support to avoid collapse. That support is rebuilt with the patient's own cartilage — often rib cartilage, because it's strong and plentiful — sometimes combined with diced cartilage wrapped in the patient's own tissue for a smooth bridge.
Staging. When there's active infection, the implant is typically removed first and the infection allowed to clear; reconstruction follows once the tissues have healed, often several months later. When there's no infection, removal and reconstruction can often be done in one operation.
Why your own cartilage is preferred
Your own cartilage becomes part of the nose, carries a low long-term risk of infection or extrusion, and can be carved to the exact shape needed. Synthetic implants remain foreign bodies for life, which is why complications can appear decades later.
Frequently Asked
Revision Rhinoplasty After a Nasal Implant or Graft Problem — patient questions, honestly answered.
Synthetic implants can displace, become infected, extrude, or cause skin thinning and contour irregularity over time. When this happens, patients may notice visibility, asymmetry, or breathing problems. Revision addresses what is present and rebuilds safe support.
Not always, and it is decided after evaluation. The surgeon first identifies what material is present and its condition using operative reports, examination, endoscopy, and sometimes imaging, then decides whether to remove, replace, or support it based on whether it is providing safe, stable support.
Continue exploring
Continue reading
Revision Rhinoplasty
Correcting prior nasal surgery and rebuilding support.
Rib Cartilage Revision Rhinoplasty
Rebuilding structure with the patient's own cartilage.
Cadaver Rib vs Autologous Rib
Comparing biologic graft sources.
Nasal Valve Collapse Treatment
Addressing breathing problems during reconstruction.
Schedule a consultation
Have your implant or graft situation evaluated.
Next step
Plans are individualized. The consultation is where that begins.
Reach the Manhattan office to schedule a private consultation with Dr. Mourad.