The questions I was curious about!! Second consultation!

I asked what problems might occur if the tip cartilage from the ear, septal cartilage, and support graft were all removed from my nose. [Doctor A] > Cannot guarantee. Contracture, depression, or a saddle nose could occur; we do not know. [Doctor B] > The problem cannot be guaranteed 100%. I have not seen a case so far in which a patient developed contracture or deformity after surgery. I asked how likely it was that the tip would become upturned, collapse, or widen after complete removal. [Doctor A] > When checking your natural nose, it is neither excessively upturned nor droopy, so complete removal should probably be fine. [Doctor B] > I do not know why other places keep scaring you. We will restore your natural nose; the tip will not become upturned or spread. I asked whether they could check during surgery how much septum had previously been harvested and, if needed, reposition it to its original location. [Doctor A] > A saddle nose could occur. If it does, we will reinforce it during surgery. We will not reposition it to the former septal site; that could risk perforation. We would reinforce the front portion. There is no foreign-body sensation at the tip, but you may be able to feel it if you put a finger inside the nose. I have seen many people like you who remove it and undergo revision surgery because of anxiety. In that case, the septum reinforced at the front can be reused. If you do not want it, we do not have to do it. [Doctor B] > We will not reposition the septum or reinforce it. The larger the dissection, the greater the risk, right? If your nose were going to collapse because too much septum had been harvested, it would have collapsed already. I heard that 5 mm had been inserted. Would removing all of it make the nose wrinkle like a balloon losing air? Would you shave it down if that happened? [Doctor A] > People with thin skin can wrinkle, and it can happen when silicone is protruding, but that is not the case with your current condition. [Doctor B] > It will not wrinkle. Among people with a natural nose, no one has a bridge as smooth as someone with silicone. Silicone is smooth, so after removal it may look bumpier than now. I asked when daily life, including drinking and smoking, would be possible after a few months. [Doctor A] > Alcohol is possible after one month; avoid smoking. [Doctor B] > After six months to about a year, once things have settled well. I asked whether problems could occur later once six months had passed. [Doctor A] > It should be fine after six months. [Doctor B] > It should be fine after six months. I have nasal deviation and a heavy feeling in my nose!! I asked whether this was because of the silicone or the septal harvest. [Doctor A] > That is too subjective to know. [Doctor B] > It could be, or it might not be. I asked whether complete removal was more dangerous than leaving autologous cartilage, because I had found too many people who had it removed again years later. [Doctor A] > Complete removal is less risky. [Doctor B] > I did not ask. After the same surgery, I developed rhinitis, sinusitis, and so on. Could these cause problems when removing the implants? I also have seasonal allergic rhinitis; would surgery during a flare be bad? I currently have severe sneezing and itching. [Doctor A] > The inside of the nose (rhinitis, sinusitis, polyps) and the outside (complete nasal implant removal) are different. Those conditions are inside the nose and unrelated to nasal implant-removal surgery. [Doctor B] > I could not ask. I asked whether my nose had undergone a lot of alterations and whether it would be difficult to operate on. [Doctor A] > We have to open it to know. Even after looking at the surgical records, things are often different once we open it. [Doctor B] > It has not undergone many alterations. This is how most surgeries are performed. I asked whether many people have a flattened bridge after silicone removal, and whether three years was okay when I had heard that people who had surgery ten years ago had become very flat, especially since 5 mm might have pressed it down more. Would you shave it down if necessary? [Doctor A] > He said he would shave it all down, so I did not ask. [Doctor B] > If you shave it, it becomes bumpy. Tissue will fill in naturally after surgery, so we do not shave it. I wanted the entire capsule removed, but some people say pain is severe after capsule removal. Does cutting it in sections reduce the chance of contracture afterward? [Doctor A] > A normal capsule does not need to be removed. It can be removed, but the skin may become thinner, and bruising and swelling may be worse. That is your choice. [Doctor B] > Remove it all. I heard that, after a Hi-Cō procedure and hyaluronic acid ten years ago, it was removed during rhinoplasty. Could it cause problems again? [Doctor A] > It could cause problems. During the rhinoplasty, the silicone and cartilage were probably manipulated after removal. We will open it during removal, and if anything remains, we will remove it additionally.