Hello, I am Dr. Peter C. Kang.
Today, I would like to share the case of a patient who required both functional and aesthetic improvements after undergoing multiple surgeries.
In this type of case, the shape of the nose became deformed as the donor rib cartilage used in prior surgeries underwent resorption.
🔍 Surgical history
- 2005: Silicone implant, Alloderm, septal cartilage
- 2017: Silicone implant, septal cartilage, donor rib cartilage
- 2017: Alar reduction
- July 2018: Silicone implant and additional correction
Main symptoms and patient requests
- Severe rhinitis
- Restricted nasal breathing
- Desire for a more defined, glamorous look
🔧 Preoperative analysis
Front, left profile, and oblique views during design consultation
1. Front view
- Crooked nose
- Pinched appearance
2. Profile view
- Nose appears elongated
- Drooping tip
- Protruding mouth observed
- High radix starting point
Design consultation photos: nostril, right profile, and oblique views
3. Nostrils
- Left-right asymmetry
- Columella tilted to the left
Furthermore, diagnostic evaluation for nasal obstruction confirmed a deviated septum and hypertrophic rhinitis.
💉 Surgical procedure details
1. Replacement of previous donor rib cartilage
- Removal of the partially resorbed previous cartilage
- Replacement with autologous rib cartilage to secure structural stability
2. Septal reconstruction
- Correction of the deviated septum
- Reconstruction using autologous rib cartilage
- Septal extension performed
3. Nasal tip improvement
- Creation of a well-defined nasal tip
- Natural lowering of the columella
- Correction of the nasolabial angle
4. Nasal bridge correction
- Lowering the radix starting point
- Improvement of the overall nasal length
[8 before-and-after comparison photos]
🌟 Surgical results
1. Frontal view improvement
Before surgery / Day 0 immediately after surgery Photos taken immediately after surgery show swelling and may differ from the final result.
- Correction of deviation
- Natural width
- Correction of the pinched look in the alae
2. Profile view improvement
Before surgery / Day 0 immediately after surgery Photos taken immediately after surgery show swelling and may differ from the final result.
- Radix starting point lowered
- Appropriate nasal length
- Refined nasal tip
- Correction of the nasolabial angle
- Improved appearance of the protruding mouth
3. Oblique view
Before surgery / Day 0 immediately after surgery Photos taken immediately after surgery show swelling and may differ from the final result.
- More natural glabella
- More natural nasal tip
- Improvement of protruding mouth
4. Nostril view
Before surgery / Day 0 immediately after surgery Photos taken immediately after surgery show swelling and may differ from the final result.
- Improvement of nostril asymmetry
- Improvement of the columellar tilt
- Correction of the pinched nose appearance
💡 Specialist opinion
Front, profile, and oblique views immediately after surgery on day 0 Photos taken immediately after surgery show swelling and may differ from the final result.
Nostril view on day 0 immediately after surgery Photos taken immediately after surgery show swelling and may differ from the final result.
The key aspect of this case was enhancing structural stability by replacing the previous donor rib cartilage with autologous rib cartilage. In addition, addressing functional issues along with the septal reconstruction helped make breathing more comfortable.
While fulfilling the patient's desire for a more prominent, glamorous profile, we maintained a natural contour. NOSELAB will continue to do our best to achieve both functional and aesthetic satisfaction for our patients.
I hope this case is helpful to those facing similar concerns.
This was Dr. Peter C. Kang. Thank you.
Thank you.
#closedrhinoplasty #autologousribrhinoplasty #revisionrhinoplasty #rhinitisrelief #autologousribcartilage #naturalnose
Limitations and risks
When autologous rib cartilage is used, scarring and pain may remain at the donor site on the chest, and pneumothorax (pleural injury) can occur rarely. Over time, the grafted cartilage may warp or undergo partial resorption.
When using donor rib cartilage, long-term follow-up is necessary because the grafted cartilage may resorb or warp.
When the septum is corrected at the same time, nasal obstruction may persist or recur, and in rare cases, septal perforation or changes in smell may occur.
Common potential risks include infection, bleeding, asymmetry, scarring, skin necrosis, and insufficient improvement; results vary depending on individual skin condition and previous surgical history.