Perforation Repair

Immediate results no need to wait up to 6 months.

Achieved using your own Multi-Cell fat

This is a unique technique developed by TRP Hospital

Symptoms

5 Warning Signs of Silicone Complications in the Nose

Sharp, Tingling Sensation at the Tip of the Nose This sign is often felt as a sharp, piercing, or electric sensation at the nasal tip when touched. It usually occurs when the silicone implant starts to press against or erode the skin from the inside. This pressure gradually thins the skin in the area, leading to a constant, uncomfortable tingling sensation upon touch.
2. Change in Color or Texture of the Nasal Tip Skin The next sign involves visible changes to the skin at the nasal tip. The skin typically becomes darker, thicker, andharder than thesurrounding normal skin. A change in skin color is a key indicator that the skin in this area is beginning to suffer from prolonged pressure or stress.
Thinning and Translucency of the Nasal Tip Skin The skin over the nasal tip may become so thin and translucent that it's possible to see the implant's outline, or it may exhibit an unusual oily sheen, particularly when exposed to light. This change in skin texture, combined with severe downward pressure, is a strong indication that the implant is close to eroding through the skin.
Recurrent Inflammation at the Same Spot This is a frequent warning sign. It is not a typical pimple or minor infection. It involves an inflammatory spot or "pimple" that, once healed, returns repeatedly to the exact same location after a short period. This persistent, recurring inflammation at one spot is a crucial signal of an issue with the underlying silicone implant.
Visible Outline of the Silicone Implant This is a serious, late-stage warning sign. When the skin has become very thin, you can clearly see the edges or outline of the silicone implant underneath the skin, especially on the side where the pressure is strongest. If this stage is reached, it is considered an urgent condition requiring immediate medical consultation for correction.

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Perforation Process

What Causes It?

The primary causes of implant extrusion (the silicone piercing through the skin) are mostly related to the silicone implant itself. The main causes include the following:

Infection : This is the most common cause. An infection leads to inflammation and the destruction of tissue around the nasal tip, causing the skin to thin and ultimately allowing the implant to pierce through.

Thin Skin at the Nasal Tip : Some individuals already have naturally thin skin at the nasal tip. Placing a silicone implant into this area can cause tension and increase the risk of extrusion.

Improper Silicone Placement or Size : If the silicone implant is too large or incorrectly positioned, it will exert constant pressure on the surrounding tissues, leading to tissue erosion and making extrusion more likely.

Previous Nasal Trauma : Accidents involving a severe blow to the nose can cause the silicone implant to shift or fracture, increasing the risk of later complications.

Pre-existing Medical Conditions : Conditions like diabetes or immunodeficiency disorders can impair the healing process, making patients highly susceptible to infection and complications following surgery.
Other Factors : Repeated squeezing of pimples or frequent nose-picking are also contributing risk factors that can irritate the area.

It is important to note that implant extrusion usually does not occur immediately after Rhinoplasty . Instead, precursory symptoms will appear before the silicone begins to pierce the skin. Patients who have undergone nasal augmentation surgery should actively monitor themselves for these initial signs and seek prompt medical attention immediately if any are noticed.

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Extrusion of the Nasal Implant

The initial sign of outright extrusion is redness on the nasal tip, indicating that the skin covering the silicone implant is being weakened and eroded. Following this, a deeper wound often appears, resembling a persistent pimple or a small ulcer that does not heal. This is not a typical blemish, but a serious wound where the skin is being destroyed by the pressure of the silicone. In some cases, tiny pieces of tissue are shed around the wound as the body tries to encapsulate the foreign object. Attempting to squeeze or manipulate this area is strongly discouraged, as this action can significantly increase the risk of infection and ultimately cause the silicone to fully break through the skin.

Further Advice and Important Reminders If the silicone implant has broken through the skin, you must not, under any circumstances, attempt to pull it out yourself.

When the silicone implant has extruded, the immediate, natural instinct for many people is to attempt to pull it out. However, this is precisely what is strictly prohibited, and this recommendation is based on clear medical reasons.

The correct course of action is to leave the silicone in place and immediately consult a specialist doctor. The best solution is for a surgeon to properly remove the silicone and repair the damage using the patient's own body tissue. This approach is vital for preserving the underlying nasal structure as effectively as possible.

Conversely, attempting to pull the silicone out yourself or leaving the site untreated for three to six months will cause the tissue at the nasal tip to shrink rapidly, leading to the formation of severe, retracting scar tissue. This can cause permanent disfigurement of the nose. Corrective treatment afterward will be significantly more difficult and complex.

In fact, there have been cases where patients have been advised by doctors to fly back from abroad with the silicone still in the nose to receive proper treatment.

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What to Expect

Progression of Complication Signs

Initial Signs: Swelling and Abnormal Itching These symptoms swelling and unusual itching in the nasal area are the earliest warnings from the body indicating that an internal abnormality is developing.
Advanced Signs: Changing Shape and Texture As time progresses, the shape of the nose begins toจนทำให้ change and feel strange. The nasal tip may start to bulge beneath the skin, causing the overall external contour of the nose to become distorted and abnormal. This is a severe sign that the underlying tissue is being significantly compromised.
Signs of Severe Inflammation: Redness and Peeling Persistent redness and peeling skin in the nasal area are signals that the body is actively fighting inflammation under the skin. This occurs due to the continuous pressure from the silicone implant causing tissue destruction.
Critical Stage: Pus and Bleeding This is the final and most dangerous warning sign, indicating a true crisis. The presence of pus and visible blood confirms that the tissue has been destroyed and an open wound has formed. Pus is the cellular remains of white blood cells fighting infection, signifying that the complication has developed into a bacterial infection. This stage represents a medical emergency that requires immediate medical consultation and treatment.

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How It Is Corrected

TRP Hospital, under Dr. Choladhis, pioneered the use of Multi-Cell Fat grafting to address complications like silicone extrusion, recognizing its value for both nasal augmentation and restoration. This method harnesses the power of Mesenchymal Stem Cells (MSCs) derived from the fat, which are primarily utilized for their ability to promote tissue healing and overall tissue improvement. Dr. Choladhiss performs the grafting using the specialized "FAT Graft Plus SVF (Stromal Vascular Fraction)" technique, unique to Teeraporn.

This innovation allows us to treat the damaged area and reconstruct the nose to look natural, smooth, and genuinely harmonious with the rest of the face. This makes it a preferred option for individuals seeking beautiful results with a natural aesthetic. Furthermore, this fat grafting technique can be used alongside silicone implants, especially for patients with a tendency toward thin skin or scar tissue (fibrosis). Using the specialized fat in conjunction with the implant helps to improve the condition of the skin and reduce the risk of future complications.

The Solution: Reconstruction and Restoration

The treatment process involves complete removal of the problematic silicone implant, followed by the strategic implantation of Multi-Cell Fat to address the extrusion issue.

The benefit of using this specialized fat for post-extrusion repair is its capacity to promote full recovery, allowing the nasal tip to regain a soft, smooth, and naturally rounded appearance. It is superior to using synthetic materials or dermal fillers, as it reduces the risks of scar tissue formation or future side effects, resulting in a final aesthetic outcome that appears as natural as possible.

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Testimonials

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Our Specialist Medical Team

Dr. Choladhis

CHOLADHIS SINRACHTANANT, M.D.
License No. 5863

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Dr. Nutty

SARINYA URATHAMAKUL, M.D.
License No. 34407

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Dr. Aom

PIYARAT POOTRAGOOL, M.D.
License No. 36825

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Dr. Whan

นพ.กฤษฎา โกวิทวิบูล
License No. 24585

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Frequently Asked Questions (FAQ)

Internal Nasal Extrusion

This condition is characterized by internal tissue damage within the nose, typically caused by infection.

Causes

Common causes include silicone implant erosion (perforation), sub-standard silicone quality, infection, and various other factors.

Is It Fixable?

Yes, it can be corrected without requiring complete removal of the existing implant, using Teeraporn’s proprietary Fat Graft Plus SVF method.

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Patient Reviews

Review: Khun Smile

Review: Khun Aem

Summary.

If you experience persistent redness and thinning skin at the nasal tip, accompanied by skin that is thicker, darker, and harder than normal, and you feel pain or a sharp, tingling sensation upon touching the nasal tip, these are definitive signs that the tissue covering the silicone implant is being compromised.

The most critical symptom is when the silicone implant is about to pierce through or has already extruded. In this event, do not, under any circumstances, attempt to touch or remove the silicone yourself. You must seek immediate consultation with a specialist doctor, specifically from TRP Hospital, for timely diagnosis and correction.

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