Why nasal threads and fat grafting fail to create a defined line: foreign body removal and rib cartilage reconstruction

Hello, I am Dr. Peter C. Kang.

Every year around this time, plastic surgery clinics enter their busiest season.

Many patients visit during the year-end and New Year period, but even with a full schedule, I make sure not to neglect recording and sharing these meaningful surgical cases.

Today, I would like to share the case of a patient who visited our clinic after failing to achieve the desired outcome from nasal fat grafting and thread lifting.

Through this case, let us examine the limitations of thread procedures and how to address them.

• December 2022: Fat grafting, absorbable and non-absorbable thread procedures

• An overall larger and higher nose

• Visual improvement in the distance between the eyes

• A clean, straight bridge line

• A natural nose without being upturned

• A natural appearance without looking operated on

• Left septal deviation

• Bilateral inferior turbinate hypertrophy

• Deviated septum

• Hypertrophic rhinitis

1. Functional improvement

• Septoplasty

• Radiofrequency submucosal resection of the inferior turbinates

2. Foreign body removal

• Complete removal of existing non-absorbable threads

• Removal of grafted fat from the nasal bridge

3. Structural improvement

• Building a stable structure using autologous rib cartilage

• Delicate adjustments to establish a straight line

• Adjustment to an appropriate height and size

1. Front view improvement

• Widened appearance of the nose was improved

• Improvement of crooked nose

• Natural elevation

2. Oblique view improvement

• Short nose lengthened to a natural proportion

• Uneven contours along the dorsum were smoothed out

• Natural elevation between the eyebrows

3. Profile view improvement

• Nasal dorsum formed into a natural, straight line

• Columella lowered to correct the nasolabial angle

• Nasal bridge and nasal tip naturally elevated

• Facial depth and dimension were created

4. Nostril view improvement

• Improved nostril asymmetry

• Columella that appeared tilted to the left was straightened

5. Functional improvement

• Relief of nasal obstruction

• Improved breathing function

• Alleviation of rhinitis symptoms

5. Overall changes

• Distance between the eyes appears more natural

• A natural line without an operated appearance

• A stable nasal tip that is not upturned

This case addressed both the aesthetic dissatisfaction from nasal fat grafting and thread lifting while meeting the functional need of relieving nasal obstruction. Although the patient had concerns about using rib cartilage, skilled technique and meticulous care helped keep pain to a minimum and achieve a stable outcome.

Rhinoplasty goes beyond simply changing height or shape; it must take into account overall facial harmony.

In this type of case as well, refining the nose produced a visual improvement in the balance between the eyes.

I will continue to provide customized surgery that carefully addresses each patient's detailed needs and concerns.

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

Thank you.

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