Thirty-Year Experience in Augmentation Rhinoplasty Using Silicone Implants: A Safer, Cheaper, Faster, and More Effective Technique

Abstract Background Debate about the advantages and disadvantages of alloplastic vs autologous implant material for dorsal augmentation rhinoplasty continues among the aesthetic surgery community. Silicone implants are criticized for high rates of infection and extrusion; however, autologous methods increase the risk of warping and resorption, and donor-site deformity, which may affect positive outcomes. Objectives The aim of this study was to demonstrate that silicone implants are a safe and reliable method of nasal augmentation when performed with proper technique, in an appropriate setting, and by qualified practitioners. Methods A retrospective chart review was conducted on 1019 patients who underwent implant rhinoplasty from February 1995 to October 2024 by a single surgeon. All procedures were performed in a QuadA-certified operating room under anesthesia by the senior author. I-shaped silicone implants were used for dorsal augmentation. Results The most common complication was due to malposition of the implant (n = 37, 4%), subjective dissatisfaction was the leading reason for revision (n = 43, 4%). Rates of extrusion and infection were low (n = 9, <1%; n = 4, <0.4%). Conclusions Compared with previously reported results for silicone implant rhinoplasty, this study found that complications can be minimized with proper techniques, such as creating a precise subperiosteal pocket, selecting an appropriate implant length, and minimizing tension at the tip. This risk profile indicates that silicone implant augmentation rhinoplasty is a safe technique and should be considered for its benefits of shorter operation times, cost-effectiveness, and aesthetic outcomes especially in ethnic populations. Level of Evidence: 4