As an industrial material, liquid silicone gel triggers tissue reaction and inflammation if injected into the human body, and its prolonged presence induces subcutaneous displacement or masses to form a typical silicone tumor (siliconoma), which causes skin deformities in mild cases and induces autoimmune diseases in severe cases. Therefore, considering health and safety, silicone gel is prohibited from being applied to the human body by the government. Nevertheless, there are patients who have undergone silicone gel injected rhinoplasty in earlier years and who seek treatment. Their noses become deformed due to the long-term effects of the infiltration of silicone gel, such as the widening of the nasal bridge, hypertrophy of the nasal tip, and ptosis of the nasal skin becoming as hard as rubber or, in severe cases, nasal obstruction, disturbance in respiration, nasal skin fibrosis, or intermittent throbbing pain. It makes patients suffer from nose diseases in the long run and also worry about the malignant changes of siliconoma. Therefore, correctly and safely fixing the problems of a silicone nose is very important because of esthetic and health considerations, and it is of great significance to rebuild patient self-confidence too.
The focal point of silicone nose reconstruction lies in removing the injected silicone gel. However, because the components of silicone gel result in tissue inflammation and fibrosis on adhesion to the skin and cause the skin to become thick and rigid like rubber, it is difficult to completely remove the silicone gel. The current practice involves simultaneously excising the visible silicone gel and adjacent sclerotic tissues, with a clearance rate of up to approximately 90%, which, however, makes the nasal skin thin and leads to regional blood circulation disturbance or persistent redness. Therefore, properly retaining the thickness of the nasal skin for rhinoplasty is critical for successful nasal reconstruction. Additionally, because the injection of silicone gel mostly does not require sterilization, the silicone gel tumor harbors numerous bacteria, so rhinoplasty implants should consider to primarily use Gore-Tex or Sili-Tex (Chimera) nasal prostheses that are less likely to cause foreign body reaction or rejection. Autologous ribs are also a good choice, and if necessary, a course of prophylactic antibiotic injection should be postoperatively given to lower the surgical risks of infection. Furthermore, it should be noted that the nasal skin would mostly become droopy after the removal of silicone gel, so the high or projected nose shape will be considered to sustain long-term and stable results.