[Dr. Koh Seung-jo's Lecture Notes] Implant-Free Rhinoplasty Part 1 👃

#HumpNose #Hump #ImplantFree #ImplantFreeRhinoplasty #Silicone #NoseBridge #NoseTip #ImplantFreeSideEffects #EarCartilage #SeptalCartilage #LowHumpNose #HighHumpNose #GangnamStation #KohSeungjo #Rhinoplasty #NoseSurgery #HumpNoseBeforeAfter #WeversPlasticSurgery

Hello everyone~

🥳Your beauty universe! This is Dr. Seo Seung-jo from Wevers Plastic Surgery :)🥳

Do you all know my nickname is ‘Koh Seung-jo’?

Today, I'm going to talk very honestly about implant-free rhinoplasty~ ^^

When undergoing rhinoplasty,

many people say, ‘I don't like silicone~~😭’.

I really like implant-free surgery, meaning surgery without silicone.

There's a sense of satisfaction in having had nose surgery without silicone,

and I believe I've performed more implant-free rhinoplasties than anyone else.

However, it's also true that many people have complained after undergoing implant-free rhinoplasty.

So, I'll explain why implant-free nose surgery is good

and what aspects lead to many complaints.

Implant-free surgery can be divided into good cases and not-so-good cases.

Good cases are when a lot of the nose bridge needs to be shaved down.

If you're creating something while shaving a lot,

implant-free surgery is very easy and good.

However, people with a hump often desire implant-free surgery,

and they always have the same concern.

They think shaving down the hump will improve it,

but for low humps, there are times when the sunken area needs to be filled.

If a lot needs to be filled, you must understand that there will be drawbacks

when doing this with an implant-free method.

Even when filling, if it's only necessary to fill above and below the hump,

then it can still be attempted.

If you take a CT scan of this hump, the bone looks like this.

(Red part)

What I mean is that the skin directly above this hump is very thin.

The skin in this area is relatively thicker. (Red hatched area)

So, even if the cartilage is a bit angled, it may appear less bumpy.

The moment cartilage is inserted into this area, it becomes a real mess.

Sometimes patients think, ‘If the skin is thin, shouldn't we avoid using silicone?’

But if the skin is thin, is cartilage okay and silicone won't show through?

Cartilage would show through much more strangely.

Because silicone still shows through smoothly,

cartilage can appear bumpy from the front,

and also from the side.

Therefore, even when the skin is thin,

cartilage should not be placed in the thinnest part of the hump,

and even if the skin is thin overall, it might be better to use silicone.

If you still want an implant-free method,

dermal grafting is definitely needed,

whether it's donor dermis or autologous dermis, you need to be aware that it's necessary.

After explaining the above and consulting, I give patients the final decision

on whether to go with implant-free or implant surgery.

Patients often ask this question:

Doctor, isn't implant-free still safer?

Regarding inflammation, it might be slightly safer probabilistically.

However, in all other aspects, implants are probabilistically better.

I tell them that implants are safer.

Considering shape and various scores,

I believe the likelihood of inflammation caused by silicone itself is not as high as one might think.

Rather, if bacteria enter during surgery,

the probability of inflammation is the same for both implant-free and implant surgery.

Building a nose is like building a house.

Ultimately, it's about having a stable support that doesn't collapse.

If it doesn't collapse, silicone can also stay comfortably, and if it can,

the likelihood of inflammation significantly decreases.

When silicone is inserted, our body encapsulates it with a capsule,

and if no dead space occurs,

silicone is also very safe.

Ultimately, what's important for safety is not whether there's silicone or not,

but whether the nose structure is stably maintained or not.

That's the core.

What's even more important is whether the nasal tip is structurally stable and supported.

That's the biggest key.

So, I hope you remember that if nasal tip surgery is maintained stably and more importantly,

and silicone is well-seated on the nose bridge,

you can live without problems.

Therefore, there's no need to insist on implant-free surgery excessively.

★Key Summary of Implant-Free Rhinoplasty Part 1★

Recommended Cases

Hump nose with a high bridge

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Requires significant shaving of the nose bridge

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Very suitable for implant-free surgery

Not Recommended Cases

Hump nose with many areas to fill

▼

Possible, but satisfaction may be low or implant (silicone) use is recommended

▼

Satisfaction UP!

Is implant-free really safer?

✅Inflammation occurrence is more about bacterial management during surgery than the presence of an implant.

✅It's important that the nasal tip support is firmly established and the nose structure is stably maintained.

https://www.youtube.com/watch?v=mKvxBsrL7mc&t=24s

💖If you have more questions?

Frequently Asked Questions

Which nose type is most suitable for non-implant rhinoplasty?

It is most suitable for high aquiline noses that require significant reduction of the nasal bridge. When a lot of bone or cartilage needs to be removed to create the desired shape, non-implant surgery without silicone can be performed easily and achieve high satisfaction.

Is non-implant surgery also good for low aquiline noses?

No, the satisfaction level may be low. For a low aquiline nose, the sunken areas need to be filled, and if cartilage is used without an implant, it can appear bumpy through the skin. In such cases, using silicone is smoother and more natural.

Is non-implant surgery safer for people with thin skin?

Not necessarily. If cartilage is inserted into thin skin, there is a greater risk of it appearing bumpy from the front or side compared to silicone. If non-implant surgery is desired for thin skin, reinforcement with donated dermis or autologous dermis is essential.

Is non-implant surgery safer against inflammation than silicone implants?

It may be slightly safer probabilistically, but the key is the structural stability of the nose. Inflammation is often caused by bacterial infection during surgery or structural problems where the nasal tip support collapses, rather than the presence of an implant. Therefore, if the support is strong, silicone is also very safe.