Double Lock Rhinoplasty With a Silicone Nose Implant, Is It a Good Idea and How Does It Keep the Implant in Place?

Key points

• Whether Double Lock rhinoplasty is a good idea depends on your skin and the proportions of your nose. This technique locks the silicone implant closely against the nasal bones to lower the chance of the nose becoming crooked or tilted.
• Our experienced doctors analyse your face with you to recommend a technique that suits your nose, such as open rhinoplasty or semi-open rhinoplasty.
• Using rib cartilage to reshape the tip structure helps add strength and can lengthen the nasal tip.
• A consultation to design your nose shape together with the surgeon is an important step in shaping a nose that suits your face.

A silicone implant shifting or becoming crooked or tilted after surgery is one of the concerns of people planning rhinoplasty and facial reshaping. This leads many people to look into whether Double Lock rhinoplasty is a good idea for improving how well the silicone implant holds and stays in a suitable position, to reduce the need for revision surgery.

In this article, S45 looks in depth at the technique for placing and locking a silicone implant, compares its features and looks at which nasal anatomy suits this technique, to help you decide and prepare before your individual assessment with a doctor.

Is Double Lock Rhinoplasty a Good Idea?

Whether Double Lock rhinoplasty is a good idea can be explained by how it helps the silicone implant hold and stay closely against the existing nasal framework. This technique places the silicone implant under the periosteum (the membrane covering the bone), together with positioning and securing the tip in a suitable place, which adds stability to the implant.

The process starts with carving the silicone implant to fit the existing nasal bones closely, to reduce gaps under the skin. The surgeon then inserts the implant under the periosteum, a deep layer, to hold it in position as the first layer, before securing the nasal tip as the second lock, to help lower the chance of the implant moving.

Two-Layer Implant Locking and a Lower Chance of a Crooked or Tilted Nose

Rhinoplasty with two-layer implant locking can help lower the chance of the implant moving or tilting, because the silicone implant is secured under the periosteum and also stitched in place as a second layer, so it sits closely along the existing nasal bones. The 2 locks work together as follows:

• placing the silicone implant under the periosteum helps the tissue under the skin hold the implant more firmly
• a second locking stitch at the tip structure helps control its direction, to reduce movement from tension in the surrounding skin

Two-Layer Fixation and a Lower Chance of Tip Extrusion

Double Lock rhinoplasty can help lower the chance of a crooked or tilted nose, because the silicone implant is held under the periosteum, which lowers the chance of it moving in the early period while the body heals and the fibres in the skin form around and support the implant.

Two-layer fixation can help reduce friction between the silicone implant and the skin of the tip, lowering the chance of tip extrusion in the future. It is a procedure with the usual risks of surgery, so results depend on your assessment and on each person’s anatomy.

During surgery, the surgeon assesses the thickness of the skin together with the existing nasal bones. If there is a dorsal hump, the surgeon may consider reshaping the bone before placing the implant, to create a more stable surface for it to hold on to.

How Does Double Lock Rhinoplasty Compare With Standard Locking?

Double Lock rhinoplasty can help add stability and keep the silicone implant in a suitable position, because the implant is held both under the periosteum and by securing the tip. This helps limit movement of the implant and lowers the chance of it shifting because of the normal tension of the skin after healing. Standard locking holds the implant under the periosteum at only 1 point.

Topic	Standard locking	Two-layer locking (Double Lock)
Implant fixation point	Held under the periosteum at 1 point	Held under the periosteum and secured with external stitches
Movement	More likely to move or lift	Implant sits closely against the bone, with less movement
Chance of becoming crooked or tilted	Higher after many years	Lower because of fixation at 2 points

Learning about and comparing the features of each technique can help you decide how to plan for the long-term shape of your nose, so that the shape suits your facial features.

Which Skin Types and Nose Shapes Suit Double Lock Rhinoplasty?

Assessing your skin together with the shape of your nose is the first step in telling whether Double Lock rhinoplasty is a good idea for you, because skin thickness and the line of the bones affect how well the implant holds. The surgeon therefore analyses the layers under the skin in order to place the silicone implant under the periosteum, lowering the chance of it moving over the long term.

Can People With Thin Nasal Tissue Choose This Type of Rhinoplasty?

If you have thin nasal tissue, you can choose rhinoplasty with the Double Lock technique. This technique can help add stability and keep the silicone implant closely against the layer under the periosteum, which is a deep layer. Placing it closely helps spread tension on the skin and lowers the chance of the implant moving and pushing against the skin of the tip.

For people with limited nasal tissue, the surgeon often considers using the Double Lock technique together with a tip graft made from your own tissue, such as ear cartilage, or acellular dermal matrix (ADM, a processed tissue graft), to add thickness and support the skin at the nasal tip so it looks smoother.

If My Nasal Base Is Tilted, Will the Nose Look Straight After Surgery?

Double Lock rhinoplasty can help add stability and keep the silicone implant closely along the existing nasal bones. However, if your nasal base is tilted, placing a silicone implant alone may have limits in fully straightening the midline, because the implant tends to follow the direction of the existing bones under the skin.

If the existing nasal bones are found to be crooked or tilted, the surgeon may consider reshaping them as well, for example with nasal osteotomy (reshaping the nasal bones), to make the base level and balanced before placing the implant. The Double Lock technique then helps support and secure the silicone implant in the next step, so it stays in line with the new midline and keeps the nose in proportion with your face.

Apart From Double Lock, What Other Nose Reshaping Techniques Are There?

Many rhinoplasty techniques have been developed to suit each person’s different anatomy and structure, for example rhinoplasty with interdomal suturing, which stitches the tip cartilages closer together and helps create a sloping bridge with a slightly lifted tip.

There is also semi-open rhinoplasty, which uses incisions inside both nostrils so the surgeon can see and work on the tip structure, helping to spread skin tension and reduce trauma to the tissue under the skin.

Next is open rhinoplasty, which uses an incision across the column between the nostrils to reshape the whole inner structure. It is suitable for reshaping the septal cartilage or using rib cartilage to build up the tip structure, to support the skin of the tip.

The right technique depends on an assessment of your nose shape, your skin and what suits you as an individual. The surgeon examines and analyses your nose to plan care that suits your facial features.

Comparing Double Lock With Semi-Open and Open Rhinoplasty

The choice of rhinoplasty technique depends on an assessment of your existing anatomy and what suits you as an individual. The Double Lock technique focuses on supporting and securing the silicone implant closely along the nasal bones, while semi-open rhinoplasty and open rhinoplasty focus on reshaping the inner cartilage structure at different levels of complexity.

Technique	Main feature	Structural reshaping
Double Lock	Two-layer silicone implant locking	Helps lower the chance of the nose shifting and becoming crooked or tilted
Semi-Open	Incisions inside both nostrils	Reduces tension at the nasal tip, with interdomal suturing
Open Surgery	Incision across the column between the nostrils	Reshapes the whole structure with rib cartilage

If you want to focus on a stable implant position to lower the chance of the silicone implant moving, the Double Lock technique helps keep it in a suitable position. If your existing nasal bones are quite crooked or tilted, or your nose is very short and upturned, the surgeon may consider open rhinoplasty with rib cartilage to build up and support the tip structure along the midline.

Why Choose S45 Clinic for Rhinoplasty

Rhinoplasty at S45 Clinic focuses on giving you a nose shape that suits your individual facial features, through an analysis of your anatomy by our experienced doctors, who put importance on assessing each person’s anatomy to plan a nose that is balanced and suits the proportions of your face.

We offer several surgical approaches to suit different nasal base structures, such as open rhinoplasty, surgery to reshape the septum and the use of rib cartilage for cases that need structural reshaping.

If you are interested in adjusting the proportions of other areas of your face, we also offer plastic surgery such as chin augmentation, forehead augmentation, and an endoscopic brow lift and facelift, to help add definition to your face.

FAQ About Double Lock Rhinoplasty

Can the Double Lock Technique Fully Prevent a Crooked or Tilted Nose?

The Double Lock technique cannot fully prevent a crooked or tilted nose, because a crooked nose is not caused only by the silicone implant moving. Other factors also affect the shape of the nose after surgery, such as an existing crooked nose, scar tissue pulling as it forms and a strong impact from outside, which can also move the nose out of position.

If a Previous Standard Rhinoplasty Left My Nose Crooked or Tilted, Can I Have the Double Lock Technique?

A crooked or tilted nose can be corrected by removing the existing scar tissue so the silicone implant can be placed under the periosteum with the Double Lock technique, which helps keep the implant along the midline. If the existing nasal bones are crooked or tilted, the surgeon may consider reshaping them as well, to make the base level and fit the new silicone implant before securing it in position.

Can the Silicone Implant Still Wobble or Move After Double Lock?

Rhinoplasty with the Double Lock technique can help support and hold the silicone implant under the periosteum, together with securing the tip, to lower the chance of the implant moving after surgery. The nose becomes more stable gradually as the body heals and forms scar tissue that surrounds and supports the silicone implant in a suitable position.

Summary

Is Double Lock rhinoplasty a good idea? This technique can help support and position the silicone implant in a suitable place by holding it under the periosteum, helping to lower the chance of the implant moving or the nose becoming tilted over the long term.

If you are interested in adjusting the proportions of your nose, you can have your facial features assessed by a doctor. If your nasal bones are crooked or tilted, planning care with open rhinoplasty allows the surgeon to position and reshape the inner structure so the nose suits your facial features. Results depend on each person’s anatomy.

Surgery and medical procedures carry risks. Find out about them and consult a doctor before you decide. Results depend on each person.