Reconstruction methods to evaluate damaged structures in a contracted nose

Hello, I am Dr. Peter C. Kang.

Today, I would like to introduce a very complex contracted nose reconstruction case.

This case illustrates overcoming multiple complications to achieve a successful reconstruction, well demonstrating the importance of high-difficulty rhinoplasty.

• Onset of contracture deformity: After undergoing a facelift immediately after nasal reconstruction, bilateral facial complications (hematoma) developed. The flap grafted during the nasal surgery underwent necrosis, resulting in recurrent contracture.

• Retracted columella, short and upturned nasal tip, and deviation/twisting toward the left.

• Due to necrosis of the flap grafted in the previous reconstruction surgery, the left membranous septal mucosa had become thinned and contracted.

1. Stem cell injection therapy

2. Septal reconstruction and contracted nose reconstruction using autologous rib cartilage

3. Removal of the nasal bridge silicone implant and augmentation of the nasal bridge with autologous rib cartilage (including lowering the radix)

4. Inferior turbinate mucosal rotation flap for left membranous septal mucosal grafting

• Retracted columella

• Nasal tip deviated to the left

• Short and upturned nasal tip

• High nasal bridge starting point

• Nostril asymmetry

• Columella deviated to the left

• Columella significantly lowered

• Correction of upturned nasal tip

• Lowering of the nasal radix

• Improvement of nostril asymmetry

• Successful contracted nose reconstruction

At last, the surgery was completed safely and successfully. Although it was a very demanding procedure, everything proceeded smoothly according to plan. Contracted nose reconstruction is a high-difficulty rhinoplasty procedure.

In patients with severe contracture, it is often necessary to first restore the normal structure as much as possible through various reconstructive procedures, such as septal reconstruction or skin grafting, before proceeding with a second stage for cosmetic surgery. In such cases, a second surgery may also be required after 6 months.

This type of case clearly shows how contracted nose reconstruction involving complex problems demands meticulous planning and advanced technique. Combining stem cell therapy and autologous tissue

reconstruction demonstrates that favorable results can be achieved even in difficult cases.

I always closely evaluate each patient's individual condition to establish the optimal treatment plan. In complex reconstruction cases, a staged approach is especially important, and formulating a treatment plan with a long-term perspective is key.

If you are considering nasal reconstruction, please be sure to consult with a specialist who possesses extensive experience. I will do my utmost to help you achieve a healthy, aesthetically pleasing nose.

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

Thank you.

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