Revision rhinoplasty using autologous rib cartilage for an upturned nose, crooked nose, and nostril asymmetry

1. Preoperative consultation

The patient visited the clinic to correct a blunt, upturned nasal tip and nostril asymmetry of this type.

2. Surgical plan

To correct the blunt nasal tip, plans were made to remove scar tissue and reposition the lower lateral cartilages. In addition, septal cartilage reconstruction was planned to shift the septum to the left, resolving both the nasal obstruction and nostril asymmetry.

3. Surgical findings

Following the previous surgery, the septum was weakened, deviated, and showed damage to the remaining cartilage, so the septum was reconstructed using autologous rib cartilage. The asymmetry of the nasal tip and nostrils, along with the nasal obstruction, were evaluated and addressed together.

4. Immediately after surgery (Day 0)Immediate postoperative photos show swelling and may differ from the final result.

5. Conclusion

In revision rhinoplasty, correcting a blunt nasal tip relies heavily on removing scar tissue around the tip and repositioning the lower lateral cartilages. Delicate removal of subcutaneous tissue (contracted tissue and scar tissue) is especially important when revision is performed within 6 months or in cases of contracted nose associated with inflammation. Furthermore, severe damage to the lower lateral cartilages can cause nostril asymmetry. In this case as well, revision surgery was performed just 3 months after a previous procedure using autologous rib cartilage; after undergoing stem cell therapy, an improved contour was achieved using autologous rib cartilage.

Dr. Peter C. Kang