Simultaneous Traumatic Fracture of Nasal Bone and Silicone Implant: Indications for Early Open Revision Rhinoplasty.

Abstract

Augmentation rhinoplasty with silicone implants is frequently performed in Asian populations. Nasal trauma in individuals with prior silicone-based augmentation may result in concurrent nasal bone and implant fractures, complicating management. The authors describe a case involving a 35-year-old man who sustained blunt facial trauma 5 years post-augmentation with an L-shaped silicone implant. CT imaging revealed fractures of both the nasal bone and implant. Early revision rhinoplasty was performed 10 days after trauma, comprising closed nasal bone reduction, implant removal, dorsal augmentation with an I-shaped implant, and tip plasty using septal and conchal cartilage grafts. At 6-month follow-up, outcomes were satisfactory with no complications. Early intervention enabled appropriate fracture management and successful structural reconstruction. This underscores the importance of evaluating both bone and implant integrity in facial trauma. Early surgical management may be appropriate when structural restoration is feasible. Current nasal bone fracture classification systems should incorporate implant fracture status to guide treatment planning in post-augmentation cases.