Reconstruction methods for an upturned nose and damaged support structures

Hello, I am Dr. Peter C. Kang.

Today, I would like to introduce a unique case in which structural problems that arose after multiple surgeries were corrected.

There are often instances where the external appearance of the nose seen during preoperative consultation differs significantly from the internal condition discovered during surgery. The patient I am introducing today was also a case where the internal condition of the nose was far worse than its external shape suggested.

• 23 years ago: Surgery with ear cartilage

• 13 years ago: Surgery with silicone implant

• 10 years ago: Septal cartilage + ear cartilage + silicone implant

• Reduce visible nostril show

• Make the philtrum appear shorter

• Correction of upturned nose

1. Front view

• Excessive nostril show

• Nostril asymmetry

• Deviated nose

• Broad nasal bridge

2. Profile view

• Upturned nasal tip

• High radix

• Protruding mouth findings

3. Oblique view

• Retracted columella

• High radix starting point

4. Nostril view

• Severe left-right asymmetry

1. Structural problems

• Loss of the septum caused by excessive harvesting of septal cartilage

• Remaining septum completely deviated to the right

• Severely damaged lower lateral cartilages

2. Reconstruction process

• Septal reconstruction using autologous rib cartilage

• Septum shifted to the left and secured

• Alar cartilage reconstructed using ear cartilage from previous surgery

1. Structural improvement

• Septal cartilage reconstructed stably in the midline

• Both lower lateral cartilages reconstructed

• Septum extended with autologous rib cartilage to lower the upturned nasal tip with structural stability in mind

• Support for the nasal tip was improved

2. Aesthetic improvement

• Excessive nostril show from the front view was improved

• Natural nasal tip position

• Improved nostril asymmetry

• The previously elongated-appearing philtrum now looks more natural

• The radix was lowered, creating three-dimensional contour

This case involved reconstructing nasal structures that were severely damaged after multiple surgeries. Although there was extensive damage, particularly to the septum and lower lateral cartilages, a successful reconstruction was achieved through the effective use of autologous rib cartilage and existing ear cartilage.

I will continue to strive for the intended result even in complex revision surgeries.

I hope this is helpful to those with similar concerns.

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

Thank you.

#revisionrhinoplasty #septalreconstruction #autologousribcartilage #functionalimprovement #customrhinoplasty #closedrhinoplasty