Why contracture and nasal obstruction develop together after multiple rhinoplasties, and how reconstruction is performed

Hello, I am Dr. Peter C. Kang.

Today, I would like to share a special case of a patient who resolved difficulties experienced after undergoing 8 rhinoplasty procedures over the course of 15 years.

1. 15 years ago: Gore-Tex + ear cartilage (revision performed because the result appeared too natural)

2. 14 years ago: L-shaped silicone implant + ear cartilage (contracture and an upturned nose developed)

3. 12 years ago: Autologous rib cartilage + autologous buttock dermis (nose on the verge of collapse)

4. 11 years ago: Autologous rib cartilage + septum, no implant (wide nasal bridge)

5. 10 years ago: AlloDerm (allergic reaction)

6. 9 years ago: AlloDerm removal + additional autologous rib cartilage

7. 2 years ago: Utilization of existing materials + autologous buttock dermis + ear cartilage

8. 1 year ago: Fat graft, followed by monthly dermal injections 7 to 8 times

Particularly notable were the allergic reaction to AlloDerm observed during the fifth surgery and the severe damage to the septal cartilage.

• Severe damage to septal cartilage

• Upturned nasal tip

• Bilateral pinched alae

• Irregular nasal tip cartilage

• Nostril asymmetry

• Severe nasal obstruction

• Depressed nasal dorsum

1. Structural reconstruction

• Total septal reconstruction using autologous rib cartilage

• Correction of the upturned nasal tip

• Lower lateral cartilage reconstruction

2. Soft tissue improvement

• Restoration of the alae via dermal grafting

• Improvement of irregularities around the nasal tip

• Scar tissue removal

3. Functional improvement

• Adjustment of columellar width via septal reconstruction to improve the external nasal valve

• Correction of nostril asymmetry

• Relief of nasal obstruction

4. Nasal bridge correction

• Scar tissue removal

• Creation of a straight bridge line

Although this was a highly complex and difficult surgery, all procedures proceeded smoothly, yielding a favorable result.

In particular, the following areas showed substantial improvement:

1. Structural improvement

• Stable septal reconstruction

• Natural nasal tip position

• Improved alar shape

2. Functional improvement

• Relief of nasal obstruction

• Widened nostrils

• Restoration of breathing function

3. Cosmetic improvement

• Smooth nasal bridge line

• Natural nasal tip

• Improved asymmetry

To resolve the complex problems caused by multiple operations, an accurate cause analysis and a systematic approach were necessary. In particular, septal reconstruction was the most critical task, through which the other associated problems could also be addressed.

I will continue to do my best to achieve the intended results, even in difficult revision surgery cases.

#closedrhinoplasty #revisionrhinoplasty #contracturecorrection #nasalobstructionrelief #naturalnose #customrhinoplasty