Why grafted dermis repeatedly absorbs, and how to reconstruct the nose

Hello, I am Dr. Peter C. Kang.

Today, I would like to introduce a special case of a patient who visited our clinic after undergoing repeated annual revision surgeries due to dermal absorption.

• 15 years ago: L-shaped silicone implant (contracture, pinched look, redness at the nasal tip)

• 14 years ago: Ear cartilage + silicone implant (aimed at improving thin nasal skin thickness)

• 11 years ago: Silicone implant + autologous dermis + ear cartilage + septum

• 10 years ago: Silicone implant + donor rib cartilage

• 8 years ago: Scalp fascia + postauricular dermis + buttock dermis

• 2 years ago: Scalp fascia + postauricular dermis + buttock dermis

• 15 years ago: Nasal filler procedure (scheduled for removal during surgery)

• Current nasal obstruction symptoms, more severe on the left side

• Deformity of nasal shape as the grafted dermis continuously absorbed after surgery

• Severe skin depression at the nasal tip due to multiple repeated surgeries

• Repeated revision surgeries undergone to address these issues

• Unnatural nasal shape

1. A stable nose without further dermal absorption

2. A natural line where the nasal tip does not project too far forward

3. A natural shape that does not look overly operated

4. Thick and stable nasal volume

5. Long-term lasting results

6. Improvement of excessive nostril show

7. Correction of the alar position

8. Improvement of nostril asymmetry

9. A rounded nasal tip that is not sharp or pointy

1. Front view

• Asymmetry caused by repeated dermal absorption

• A pinched-looking nasal tip due to contracture

• Deviated nasal bridge

• Excessive nostril show

• Noticeable asymmetry of the nostrils and alae

2. Profile view

• High radix starting point

• Obtuse nasolabial angle

• Unnatural nasal line

3. Nostrils

• Severe asymmetry

• Columella deviated to the right

• Scar tissue in the right nostril

1. Structural reconstruction

• Reconstruction of the severely damaged septum using autologous rib cartilage

• Reconstruction of the lost lower lateral cartilage

• Performance of nostril elongation

2. Volume improvement

• Efficient recycling of existing autologous dermal tissue

• Reinforcement around the cartilage to secure stability

• Creation of overall volume

3. Functional improvement

• Septoplasty and septal reconstruction

[8 before-and-after comparison photos]

1. Front view improvement

• Improvement of excessive nostril show

• Marked improvement in nostril asymmetry

• Natural bridge line

• Correction of deviation

2. Profile view improvement

• A natural line achieved by lowering the radix

• Improvement in the upturned appearance by lowering the nasal tip position

• Nasal length improved through appropriate correction of the nasolabial angle

4. Nostril view improvement

• Straightened columella

• Improved symmetry between the left and right nostrils

• Natural nostril shape

• Improvement of scar tissue in the right nostril

Contracture deformities resulting from repeated dermal absorption and multiple revision surgeries are among the most challenging issues in rhinoplasty. In cases like this, stable results were achieved by thoroughly adhering to the following principles:

1. Thorough removal of previously damaged tissue

2. Solid and stable structural reconstruction

3. Creation of a natural line and volume

4. A comprehensive approach for long-term stability

In particular, to prevent dermal absorption and repeated revision surgeries that the patient was concerned about, we focused on maximizing the use of autologous tissue and building a stable support structure.

We will continue to listen carefully to our patients' concerns and do our utmost to achieve long-term stable results.

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

Thank you.

#closedrhinoplasty #revisionrhinoplasty #dermalabsorptionimprovement #contracturecorrection #naturalnose #rhinoplastyrevision #customrhinoplasty