Autologous rib cartilage implant-free revision rhinoplasty for contracted nose and nostril asymmetry

Hello, I am Dr. Peter C. Kang.

Today, I would like to share a revision rhinoplasty case of a 22-year-old male patient who suffered from inflammation and contracted nose deformity after multiple rhinoplasty surgeries.

Through this case, let us examine the risks of frequent rhinoplasty and the importance of safe reconstruction.

Design consultation: front, left oblique, and profile views

• 2022: Zygoma reduction, jaw surgery

• 2023: Septal cartilage + ear cartilage + implant-free alar reduction

• 2023: Revision rhinoplasty using autologous rib cartilage

• 2024: Endonasal cartilage + implant-free -> Inflammation occurred after 1 week, managed with medical treatment

1. Improvement of nostril asymmetry

2. Overall improvement of nasal shape

Right profile, oblique, and nostril views during design consultation

1. Front view: Excessive nostril show, nostril asymmetry, crooked nose

2. Profile view: Low nasal bridge, short and upturned nasal tip

3. Nostril view: Columella deviated to the left, nostril asymmetry

Precautions

Because not enough recovery time has elapsed since the previous surgery, an immediate revision is difficult. Once treatment at the previous clinic is completed, and while undergoing stem cell therapy, revision rhinoplasty is expected to be feasible in about 3 months.

1. Lateral osteotomy for crooked nose correction

2. Reconstruction of the nasal bridge and nasal tip using autologous rib cartilage (implant-free rhinoplasty)

3. Septal reconstruction surgery (required due to severe septal damage from previous surgeries)

4. Correction of the nasolabial angle

Profile view:

• The low appearance of the glabella and the uneven dorsum were naturally corrected

• The appearance of a protruding mouth improved as the nasolabial angle was corrected

Oblique view:

• The blunt, short-appearing nasal tip became better defined

• The previously low glabella was naturally elevated

Front view:

• The crooked appearance was improved

• Excessive nostril show was improved

• Nostril asymmetry significantly improved

Nostrils:

• The leftward deviation was straightened

• Improved nostril asymmetry

Implant-free surgery is an approach that uses autologous tissue such as cartilage or dermis instead of synthetic materials like silicone or Gore-Tex. The advantages and disadvantages of this method are as follows:

Advantages:

• Reduced risk of inflammation

• Natural feel

Disadvantages:

• Predicting the result can be challenging

• Cosmetic refinement may be more limited compared to silicone implants

Careful selection is necessary based on each patient's individual circumstances and goals.

Finally, frequent rhinoplasty procedures can lead to serious complications. For those considering revision rhinoplasty, especially when a contracted nose deformity has developed, please be sure to make decisions carefully and allow an adequate recovery period. Through consultation with a specialist, choose the approach best suited for you to achieve a safe and satisfying result.

I will always do my best to support your health and natural aesthetic harmony.

If you have any questions, please feel free to leave a comment.

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

Thank you.

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