Removal of mesh inside the nose and autologous rib cartilage reconstruction

Hello, I am Dr. Peter C. Kang.

Surgical history: The patient's requests

• 2018: Rhinoplasty using septal cartilage, mesh, and osteotomy

• Desired outcome: A natural line, a subtle nose that does not draw excessive attention

Preoperative analysis

1. Front view

• Blunt and broad nasal tip

• Broad nasal bridge

• Nostril asymmetry

2. Profile view

• High radix starting point

• Bulbous nasal tip

• Drooping columella

3. Oblique view

• An overall bulbous and wide nose

• Drooping nasal tip

4. Nostrils

• Nostril asymmetry

Surgical plan: Strategies for addressing complex problems

1. Lateral nasal bone osteotomy: Narrowing the width of the nose

2. Adjusting the height of the nasal bridge: Lowering the radix starting point

3. Refining the nasal tip:

• Partial removal of subcutaneous tissue

• Repositioning of lower lateral cartilage

• Cartilage suturing

4. Using autologous rib cartilage:

• Septal reconstruction and septal extension

• Augmenting the nasal dorsum

5. Nasolabial angle correction

Surgical procedure: Unexpected challenges

• Identified issues:

1. Discovery and complete removal of 4 pieces of mesh (2 on each side)

2. Severe damage to septal cartilage

Surgical results: A natural nose with high patient satisfaction

• A slimmer nasal tip

• Natural bridge line

• Improved facial proportions

• Corrected columella

Noticeable changes: Before & after photos

Comparing the before-and-after photos clearly shows the transformation. The bulbous and spread nasal tip became slimmer, and the nasal bridge line achieved a natural contour. By lowering the radix starting point between the eyebrows, overall facial balance improved, successfully delivering the subtle and natural nose the patient desired.

The core of rhinoplasty: Safety and expertise

Cases like this highlight the critical importance of safety and surgical expertise in rhinoplasty. In particular, the risks of using mesh should be recognized. Mesh can lead to inflammation and contracture, making it inappropriate for nasal surgery.

For those considering rhinoplasty, I strongly advise consulting a specialist who uses techniques and materials with established safety profiles. In revision rhinoplasty, accurately assessing the anatomical status from prior surgeries and applying a customized approach is essential.

Closing remarks: A commitment to your well-being

Patient safety and satisfaction are always the top priorities. Rather than merely altering nasal shape, the goal is customized rhinoplasty tailored to overall facial balance and harmony.

A natural and healthy nose goes beyond cosmetic change, fostering confidence and quality of life. NOSELAB will continue to do its utmost for your natural beauty and well-being.

This was Dr. Peter C. Kang. Thank you.

Thank you.