Five long-term case reports (average 15 years) of saddlenose correction using cast Silastic implants.

A 15-year review of patients who underwent silicone implants to the nasal bridge was conducted. None of my implants had to be removed because of either hematomas or infection. To my knowledge, only one implant has been removed for any reason over the last 10 years. Another nasal implant was removed by a surgeon in New Orleans and was replaced by a rib cartilaginous graft, which, within 2 years, severely curled, causing a nonacceptable result. This cartilage graft was removed and replaced with a second silicone implant and, to my knowledge, was still satisfactory and in place 10 years postoperatively. Insertion of implants with lateral nasal bone infracturing and submucous resection, along with tip reduction, is now performed in almost all patients. Tip elevation, when necessary, is accomplished by rotation of the nasal floor and columella up the maxillary spine (and septal cartilage) to obtain a maximum of 6 mm of elevation, some of which is lost following subsidence of swelling and/or dissolution of the suture material.