First of all, I’m looking into silicone removal + nasal tip refinement because my nasal bridge silicone moves! My original nose was very low and wide, and I didn’t have osteotomy or any other manipulation done. If I get it removed, it’ll be my 3rd surgery, and I’ve had open surgery twice! The last open surgery was nasal bridge silicone + autologous costal cartilage at the nasal tip (they said it was overlaid on top of the septum)
1. A (only examined by palpation) After looking at photos of my natural nose, they said only the silicone can be removed, and the nasal tip can be adjusted again by trimming the existing autologous costal cartilage to match my original nasal bridge
-In other reviews, people said the consultation was extremely detailed, but for me, it was more relatively simple than I expected..? The hospital where I had surgery said that since my nose had been raised a lot, if I only removed the silicone, it would become depressed? or collapse lol. But there wasn’t really any talk like that, and they said if there’s a step-off, they can grind cartilage and fill it in I wondered if it was a simpler surgery than I thought..? and the surgery fee was also set the lowest They said it could be done in the direction I want, so I felt relieved, but somehow, by my standards, I don’t think the explanation was sufficient. Still, I’m planning to go once more for another consultation! I feel like I didn’t prepare my questions well..
2. B (showed CT + 3D) Complete removal possible, but MegaDerm must be laid down no matter what, nasal tip would be cartilage tying
-On the CT, they said the highest part of the silicone inserted is 7 mm (the hospital where I had surgery said 5 mm was inserted). So they said it would definitely become depressed, and donor dermis (MegaDerm) must be placed. They said not placing it is not an option Complete removal is possible, and for the nasal tip, if MegaDerm is placed, they said they can do cartilage repositioning + tying to match that and make it as similar as possible to the current front view (surgical nose) First of all.. the director seemed very knowledgeable about noses, and explained things in great detail too. But in the middle, while talking about directors at other hospitals, they said things like that director there doesn’t seem able to tidy up alar cartilage.. and many people who had surgery there came to our hospital for revision surgery.. Seeing them say things like that made me go, hmm? It felt like something they didn’t really need to say..? The surgery fee was the most expensive. Probably because it felt more like re-correction rather than removal..? But since I’m getting things removed, I don’t really want to put anything in, so although I agree with the director’s surgical direction, I wasn’t drawn to it..
3. C (only examined by palpation) Recommended removing only the silicone. Since my columella is on the shorter side, if the nasal tip is removed it could become even shorter and retract, so either preserve the autologous costal cartilage, or if that can’t be preserved, use septal cartilage, and if that’s not possible either, reposition with ear cartilage. If the nasal bridge is bumpy, they might grind that down a bit They said they would grind cartilage and put it in for any step-off
-Among all the hospitals I’ve been to so far, this consultation matched my needs the most, and I felt like they pointed out the issues with my nose (that the columella is on the shorter side, the shape after surgery, etc..?) Overall, it was a very calm consultation I was also very worried about the depression part that hospital B mentioned, so when I asked, they said that could happen, and because of that, they also explained a method of trimming things before going in.. It felt like, “I’m worried because of this” > “we’ll supplement that issue like this,” so it felt like the answer to my question was exactly given? I’m planning to go again later with my mom
4. D (only examined by palpation) Complete removal possible. If I’m a bit worried about the nasal tip spreading, there are many methods, such as cutting and tying the alar cartilage or doing nasal tip tying The choice is up to me
-I went here while I was at it because it’s often mentioned as having good post-op results and it was easy to book a consultation Overall, it was a detailed consultation. They showed me other patients’ surgical process (they first asked if I was okay with seeing that kind of thing, then showed me), and explained things like “this is the support structure, this is the alar cartilage,” so there were many parts where I was like, ah?! But first of all, they said if only the silicone is removed, it can become bumpy. But they said they wouldn’t shave it down (they said they’d only slightly trim the severe areas). Why.. because it’s not something you can just shave easily, and if they shave it and it later fills back in, it can become even bumpier.. So when I asked what happens if it doesn’t fill back in, they said I’d just have to live with it, and for things like a step-off, if it’s too severe, they can grind cartilage and put it in or do something like that. But then it can become calcified, and if that happens, it can become bumpy again But they said it probably wouldn’t be severe to the naked eye When I said a tall silicone implant had been inserted, they said, “Then that changes the story again?” and explained another plan too In the end, they said they won’t know until they open it up, and they can’t give me a definite answer right now! They said whether it’s removal or correction, that’s my choice, so I should choose while accepting some degree of risk! And they told me not to go to too many consultations here and there, because hearing all kinds of things will confuse me It was okay in that they didn’t only say good things, but I felt unsure because I didn’t get confidence about how they would respond if a problem occurred, so it felt ambiguous..
I wrote this in a bit of detail because I wanted to keep a record and share it too I’m planning to have surgery around the end of this year, so I’ve booked more consultations too.. If anyone here has consultation reviews or information they know, I’d like you to share! If you’re curious about anything, leave a comment and I’ll answer!