How to reconstruct an old contracted nose using autologous rib cartilage

Hello, I am Dr. Peter C. Kang.

Today, I would like to introduce a case in which a severe contracted nose that developed 15 years after rhinoplasty was successfully corrected.

Reconstruction of a contracted nose is not simply a revision rhinoplasty; it is a highly challenging surgery that requires total reconstruction.

The patient underwent nasal surgery in 2008 using a silicone implant and septal cartilage, and had revision surgery the following year due to contracture. Currently, the patient was suffering from nasal obstruction and rhinitis symptoms.

On the front view, excessive nostril show was visible and the tip skin was puckered. On the profile, the tip was severely upturned and the nasolabial angle was very wide. The radix was also set high, and the nostril view revealed asymmetry with a columella deviated to the right.

The most crucial aspect of contracted nose reconstruction is the thorough reconstruction of damaged cartilage frameworks. To achieve this, a step-by-step approach was carried out as follows.

First, stem cell injection therapy was administered to improve the skin condition and prepare the skin envelope to stretch sufficiently.

During surgery, the contracted scar tissue beneath the tip skin and the capsule surrounding the previous silicone implant were completely removed. Because almost no septal cartilage remained, complete reconstruction was performed using autologous rib cartilage, and the lower lateral cartilages—which remained only in outline—were also thoroughly reconstructed.

The nasal bridge, which had become severely flattened after removing the implant and capsule, was elevated with autologous rib cartilage in harmony with the nasal tip.

As seen in the day 0 photos immediately after surgery, the overall structure of the nose has been stably improved. In particular, the deformity caused by contracture was resolved, restoring natural nasal contours. Photos taken immediately after surgery show swelling and may differ from the final result.

Correction of a severe contracted nose is one of the most demanding procedures in nasal surgery. At its core lies the complete reconstruction of the septal and lower lateral cartilages, which requires advanced technique to safely release and stretch the contracted skin envelope.

At NOSELAB, we have shared new beginnings with many patients suffering from contracted noses. To honor our patients' trust and confidence, we promise to continuously study and advance toward achieving better results.

I hope this case offers helpful insight to those struggling with complications of a contracted nose.

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

Thank you.

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