When I was looking into removal, I got a lot of help from this community, so I’ll leave a review too. First, I liked the shape after my first surgery, but because the silicone was showing through, I went to another hospital and had revision surgery. At the hospital where I had the revision, they placed the ear cartilage at the nasal tip too large, and since my skin is thin, the cartilage is now showing through roundly at the tip of my nose, so I’m looking into removal. I don’t want to be stressed about my nose anymore, so if possible I’m looking into full removal. But there was an opinion that my septum may have become weakened from rhinitis surgery, so during surgery I’m planning to leave it in or remove it depending on the doctor’s judgment.
1. ㅊㅁ Full removal possible. It won’t collapse. It will return to my previous nasal tip. They will do nasal tip cartilage repositioning. My skin is thin, but not to a worrying degree. (But then it makes me wonder if the revision hospital did the surgery wrong;) Any step-off or depression would be supplemented with AlloDerm.
2. ㅅㅇ Full removal is possible, but there is concern because of the septal support strut. When opened, if the septum has been over-harvested or is weakened, it cannot be removed. To correct the crooked nose, the support strut needs to be removed, but if it cannot be removed, correction won’t be possible.
3. ㅅㅅㅇ If it has to return as much as possible to the original nose, it’s better to leave the nasal tip support strut. If removed, it could collapse. Possibility of saddle nose. Their method is to remove everything including the support strut, then reconstruct the support strut again at the nasal tip. (No pig nose) They proceed with nasal tip cartilage repositioning. However, when reconstructing the support strut, if there isn’t enough cartilage, they may take it from the ear. (Possibility of ear deformity) The nasal bridge where the silicone was removed will probably be ground flat/square, and they said they will smooth this into a curve.
4. ㅍㄹㅁ Full removal possible. However, if the septum has become too weak, it could collapse, so if they judge that to be the case, they will leave only the autologous costal cartilage inside the nose as a support strut. (Pig nose possible) They proceed with nasal tip cartilage repositioning. The nasal tip will come out somewhere between my original nose and my surgical nose. A step-off won’t occur if the surgery is done well. If it occurs because there was an original problem, they handle it by grinding cartilage and applying it. My skin isn’t thin enough to worry about. No dermis needed.
So I finished all the consultations, and at the hospital where I had my revision, they said they were worried because the skin at my nasal tip is too thin if I get removal done. But after going around for consultations, they said it’s not thin enough to worry about, so I do feel relieved. I’m deciding between ㅅㅅㅇ and ㅍㄹㅁ, but ㅅㅅㅇ is based on the concept of reconstructing the nasal tip support strut, so when I’m trying to do full removal, I’m confused about whether it makes sense to build a support strut again because of shape concerns. ㅍㄹㅁ said they would use the existing autologous costal cartilage only inside the nose to keep it from collapsing, so I feel like their direction matches mine well. They said full removal is also possible if I don’t need a support strut, but I’m still a bit worried in case I end up with a saddle nose..