Previous surgery details before removal: septal extension strut, shield graft, stacked graft, custom silicone about 4 mm (rhinoplasty 7 months ago)
Reason for removal: persistent feeling of tightness, pressure, and shifting from the silicone; the septal extension strut was extremely hard (columella and nasal tip felt hard like stone - like touching an elbow bone); foreign-body sensation and fixed feeling in the columella when smiling; nose looked upturned; nostril changes (pointed, triangular)
Consulted at 4 places including the surgery clinic: confirmed through CT that a long silicone implant was inside; some doctors also said the nose looked upturned; some clinics said they could restore it to my original shape, while others said they could not; they also made me consider the possibility that the nasal bridge had been shaved down; I learned that septal cartilage could be stored again (cf. the doctor at the surgery clinic said I should try enduring the foreign-body sensation longer. Without autologous cartilage, fine adjustment of the alar cartilage would be difficult. Since the pointed, triangular nostrils were tied, it would be hard to resolve without other cartilage. The consultant spoke in the direction of not removing it, saying the nose could change strangely. The cost quoted was comparable to a removal-specialized clinic.)
Choosing the removal clinic: a place with many removal cases. I avoided places that were too certain about restoring the original nose, and chose based on places that presented things to think about regarding removal. A place where the doctor handles every step from start to finish. A place where I could ask the doctor directly.
Things I worried about before removal: capsule, depressed/shaved nasal bridge, re-storing septal cartilage -> Remove only part of the capsule, smooth it if the nasal bridge was shaved, do not re-store the septal cartilage (they said it could be used for revision surgery later if the nose became upturned. I did not put it back in because I was worried about a foreign-body sensation.)
Things confirmed with the original surgery clinic before removal: Until I got my operative record, I thought there was only a septal support strut, but it was an extension strut and several layers had been stacked on the nasal tip. They said they had not shaved the nasal dorsum. Since it was custom silicone, I guess not shaving would be right (when I asked the removal clinic about this, they said the nasal bone is often shaved even with custom implants. Shit. I paid more because it was custom.)
Result confirmed after removal: the silicone was long and reached almost to the nasal tip. The nasal bridge had been shaved ㅜㅜ
Removal clinic: changed clothes and washed my face. Waited for consultation with the doctor. We made the final decisions together on the parts I had worried about, checked them carefully several times, and I showed photos of my original nose again (front, base view, side, etc.). Consultation completed. Sedation anesthesia. I did not feel a black-hole sensation at all; when I woke up, surgery was done. I think it took about 2-3 hours. After recovering sufficiently in the recovery room, the doctor explained the surgical results again. I checked the removed silicone, cartilage, capsule, and scar tissue. Through photos, I checked before and after cartilage repositioning and the smoothing of the shaved nasal bridge. Then I got my prescription, picked up the medicine at the pharmacy, and went home by subway. It takes about 2 hours to get home, but since there was no nasal packing and no splint, taking the subway was not difficult, I could breathe completely well, and I had no problem walking.
Day of surgery: the nasal tip was almost similar to my original nose. The bridge was broad, whether from depression or shaving. A few hours later, swelling started coming up and bruising slowly appeared too. It did not hurt at all, but if I touched it, the bone and flesh hurt. Nostrils round.
After one week: external stitches removed. The doctor treated it directly. Runny mucus and nasal crusts completely removed. Felt totally refreshing.
From the day of surgery until nearly 2 weeks: swelling and bruising are slowly going down. The bridge is still broad. As swelling goes down, the operated-nose shape is showing little by little. Almost all the various foreign-body sensations are gone. The distinct hardness and fixed feeling from the strut are gone. The part of one nostril that had been pinched and triangular is slowly appearing.
Over these 2 weeks, the swelling and bruising have been gradually going down and I am recovering. Today I saw the operated-nose look at the nasal tip, so I thought I should write a review. Until a few days ago, when I pressed the nasal tip, it felt empty inside as if there was no flesh, but today it feels bouncy? like the flesh has filled in. I think it is changing little by little.
I wanted to recover the image of my original nose, and right now I think it has recovered to some extent. But seeing the operated-nose look, I feel like I will not be completely free from the operated nose. I will watch the progress more and share.
I hope my review helps even a little.
+ Addition: I had the removal done at a place that does not use nasal packing, splint, or taping.
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