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Clinical Analysis of Nasal Bone Fracture in Patients Who Have Previously Undergone Dorsal Augmentation Using Silicone Implants: A Pilot Study



There are no studies about the treatment of nasal bone fractures in patients with dorsal augmentations using silicone implants. We aimed to describe the characteristics of nasal bone fracture in patients who underwent rhinoplasty and compare the difference between closed reduction and conservative treatment of nasal bone fractures in patients with a history of rhinoplasty.


Between January 2013 and June 2018, a total of 463 patients were admitted to our center for nasal bone fracture; 17 patients with nasal bone fractures who underwent rhinoplasty were included, of which, five underwent closed reduction in the nasal bone and 12 underwent conservative treatment. Three of 12 patients who were initially treated conservatively underwent a secondary rhinoplasty for esthetic improvements. All patients were classified according to fracture site and the presence of a nasal septal fracture—in accordance with the modified Murray classification—and were analyzed for the correlation between fracture type and disease course.


The nasal bone fracture types per computed tomography findings were unilateral (n = 13), bilateral (n = 4), septal (n = 1), and M-type (n = 1). No significant differences in fracture site (P > 0.05) and the presence of a nasal septal fracture (P > 0.05) were found between the groups. Fracture type did not significantly differ among patients who underwent closed reduction, conservative treatment without secondary rhinoplasty, and secondary rhinoplasty (P > 0.05).


Despite risking traumatic capsular rupture, implant removal is seldom required and closed reduction is recommended if visible deviations are present; otherwise, only conservative treatment is recommended.

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  1. Choi SM, Choi HJ, Kim CH, Ahn HS, Kang SG, Jung SG (2008) Characteristics of nasal trauma in the implanted nasal prosthesis. J Korean Soc Plast Reconstr Surg 35:597–602

    Google Scholar 

  2. Ondik MP, Lipinski L, Dezfoli S, Fedok FG (2009) The treatment of nasal fractures: a changing paradigm. Arch Facial Plast Surg 11:296–302

    Article  Google Scholar 

  3. Chen C-T, Hu T-L, Lai J-B, Chen Y-C, Chen Y-R (2010) Reconstruction of traumatic nasal deformity in Orientals. J Plast Reconstr Aesthet Surg 63:257–264

    Article  Google Scholar 

  4. Graham BS, Thiringer JK, Barrett TL (2001) Nasal tip ulceration from infection and extrusion of a nasal alloplastic implant. J Am Acad Dermatol 44:362–364

    CAS  Article  Google Scholar 

  5. Tham C, Lai Y-L, Weng C-J, Chen Y-R (2005) Silicone augmentation rhinoplasty in an Oriental population. Ann Plast Surg 54:1–5

    CAS  Article  Google Scholar 

  6. Jung DH, Kim BR, Choi JY, Rho YS, Park HJ, Han WW (2007) Gross and pathologic analysis of long-term silicone implants inserted into the human body for augmentation rhinoplasty: 221 revision cases. Plast Reconstr Surg 120:1997–2003

    CAS  Article  Google Scholar 

  7. Zeng Y, Wu W, Yu H, Yang J, Chen G (2002) Silicone implant in augmentation rhinoplasty. Aesthet Plast Surg 49:495–499

    Google Scholar 

  8. Murray J, Maran A, Busuttil A, Vaughan G (1986) A pathological classification of nasal fractures. Injury 17:338–344

    CAS  Article  Google Scholar 

  9. Rohrich RJ, Adams WP Jr (2000) Nasal fracture management: minimizing secondary nasal deformities. Plast Reconstr Surg 106:266–273

    CAS  Article  Google Scholar 

  10. Hwang K, You SH, Kim SG, Lee SI (2006) Analysis of nasal bone fractures; a six-year study of 503 patients. J Craniofac Surg 17:261–264

    Article  Google Scholar 

  11. Hong ST, Kim DW, Yoon ES, Kim HY, Dhong ES (2012) Superficial mastoid fascia as an accessible donor for various augmentations in Asian rhinoplasty. J Plast Reconstr Aesthet Surg 65:1035–1040

    Article  Google Scholar 

  12. Hwang NH, Dhong ES (2018) Septal extension graft in asian rhinoplasty. Facial Plast Surg Clin N Am 26:331–341

    Article  Google Scholar 

  13. Suh MK, Ahn ES, Kim HR, Dhong ES (2013) A 2-year follow-up of irradiated homologous costal cartilage used as a septal extension graft for the correction of contracted nose in Asians. Ann Plast Surg 71:45–49

    CAS  Article  Google Scholar 

  14. Kim HS, Park SS, Kim MH, Kim MS, Kim SK, Lee KC (2014) Problems associated with alloplastic materials in rhinoplasty. Yonsei Med J 55:1617–1623

    Article  Google Scholar 

  15. Ogino A, Onishi K, Nakamichi M, Okaneya T (2018) Navigation-assisted nasal bone osteotomy for malunited fracture. J Craniofac Surg 29:156–158

    PubMed  Google Scholar 

  16. Lu GN, Humphrey CD, Kriet JD (2017) Correction of nasal fractures. Facial Plast Surg Clin N Am 25:537–546

    Article  Google Scholar 

  17. Kim ST, Jung JH, Kang IG (2017) Is surgical navigation useful during closed reduction of nasal bone fractures? J Craniofac Surg 28:e208–e210

    Article  Google Scholar 

  18. Jeon M, Kim Y (2018) Correlation between the existing classifications of nasal bone fractures and subjective patient satisfaction. J Craniofac Surg 29:1825–1828

    PubMed  Google Scholar 

  19. Lim H, Kang KR, Koh SH, Jung SW, Jung S (2017) Postoperative changes after closed reduction of nasal fracture. J Craniofac Surg 28:1649–1653

    Article  Google Scholar 

  20. Hwang K, Yeom SH, Hwang SH (2017) Complications of nasal bone fractures. J Craniofac Surg 28:803–805

    Article  Google Scholar 

  21. Yoon T, Kim Y (2016) Postoperative Satisfaction in nasal bone fracture patients who had rhinoplasty. J Craniofac Surg 27:1707–1710

    Article  Google Scholar 

  22. Jeon SP, Kang SJ, Kim JW, Kim YH, Sun H (2013) New nasal fracture classification for patients with silicone implants. J Plast Surg Hand Surg 47:363–367

    Article  Google Scholar 

  23. Nishioka H, Kondoh S, Yuzuriha S (2018) Convex bone deformity after closed reduction of nasal bone fracture. J Plast Reconstr Aesthet Surg 71:85–89

    Article  Google Scholar 

  24. Lee IS, Lee JH, Woo CK, Kim HJ, Sol YL, Song JW, Cho KS (2016) Ultrasonography in the diagnosis of nasal bone fractures: a comparison with conventional radiography and computed tomography. Eur Arch Otorhinolaryngol 273:413–418

    Article  Google Scholar 

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Correspondence to Eun Sang Dhong.

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Namgoong, S., Yang, JP., Han, SK. et al. Clinical Analysis of Nasal Bone Fracture in Patients Who Have Previously Undergone Dorsal Augmentation Using Silicone Implants: A Pilot Study. Aesth Plast Surg 43, 1607–1614 (2019).

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  • Nasal bone fracture
  • Augmentation rhinoplasty
  • Silicone implant
  • Disease course