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Plast Reconstr Surg. 2007 Dec;120(7):1997-2003.

Gross and pathologic analysis of long-term silicone implants inserted into the human body for augmentation rhinoplasty: 221 revision cases.

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Simmian Aesthetic Clinic, Division of Facial Plastic and Reconstructive Surgery, Department of Otorhinolaryngology, Kangdong Sacred Heart Hospital, Hallym University School of Medicine, 445 Gil-dong Gangdong-gu, Seoul 134-701, South Korea.



In augmentation rhinoplasty, delayed morphologic changes are often observed with silicone implants, despite them being known as a safe implant material. The purpose of this study was to identify the cause and time course of delayed shape changes of silicone implants, through the long-term evaluation of inserted implants and their surrounding nasal soft tissues after their removal at revision rhinoplasty operations.


Two hundred twenty-one silicone implants removed during revision rhinoplasty were studied. The period of insertion ranged from 1 month to 25 years, with an average of 6 years 7 months. Calcification within the silicone implants and, when available, the capsular soft-tissue attachments were examined with the naked eye and light microscopy.


Calcification was first observed grossly with the naked eye after 5 years 8 months of insertion. With light microscopy, calcification debris could be seen after 4 years. After implant insertion for more than 9 years, focal calcification could be seen in 50 percent of implants. When implants had been inserted for more than 15 years, a denatured type of large calcification was clearly observed. Plasma cell, macrophage, and neutrophil proliferation was noted in the soft-tissue capsule surrounding the superficial calcifications in those individuals with an early inflammatory response, and lymphocyte proliferation was noted in those with a late inflammatory response.


Silicone implants were noted to induce calcification when inserted for a long time, causing long-term morphologic changes. This should be taken into consideration when choosing silicone implants for augmentation rhinoplasty.

[Indexed for MEDLINE]

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