Correction of a Visible Silastic Implant Using the Dual-layered Capsular Flaps

Alloplastic implants used for dorsal augmentations can induce surgical and cosmetic complications. One of these cosmetic complications is when the implant is visible through the skin. In these cases, it is recommended to use an autologous soft tissue to reinforce the area between the skin and the implant. Recently, a patient visited our institute complaining of a previously inserted silastic implant being visible through the skin. Based on the implant, we hypothesized that the surrounding soft tissue might have formed 2 capsular layers, and the implant might have separated from the capsular. During the revision rhinoplasty, we peeled off the 2 capsular layers and used them to reinforce the area between the implant and skin without harvesting autologous tissue. This procedure had a satisfactory surgical outcome and a shorter operative time than harvesting autologous tissue. Here, we describe our experience and share lessons from this case.