Why Medpor extrudes through the nasal mucosa, and how removal and reconstruction are performed

Hello, I am Dr. Peter C. Kang.

Today, I would like to introduce a case in which a severely inflamed nose caused by Medpor mucosal extrusion was resolved through autologous rib cartilage reconstruction.

• Age 18: Deviated septum surgery + cartilage tie

• Revision/touch-up: Appeared crooked with a drooping tip

• 3 years later: Silicone implant removal, Alloderm procedure

• February 2023: Alloderm nasal bridge revision surgery

• August 2023: Alloderm revision surgery

• December 2024: Alloderm and silicone implant revision surgery

• Nasal endoscopy: Medpor extrusion through the mucosa in the left nasal cavity

• CT scan findings: Left septal deviation - diagnosed with deviated septum

• CT scan findings: Bilateral inferior turbinate hypertrophy - diagnosed with hypertrophic rhinitis

• Multiple fragments of Medpor found in the nasal tip area

• Acute inflammation surrounding the left mucosal extrusion site

• Severe damage to the septal cartilage caused by inflammation

• Most of the left lower lateral cartilage lost

• Inflammation observed around the existing Alloderm as well

1. Treatment of damaged areas

• Complete removal of the extruded Medpor

• Debridement of acute inflammatory tissue and thorough irrigation

• Suturing of the damaged mucosa

• Removal of contaminated silicone implant and Alloderm

2. Structural reconstruction

• Total septal reconstruction using autologous rib cartilage

• Reconstruction and restoration of the lost lower lateral cartilage

• Osteotomy performed for dorsal hump reduction

3. Shape improvement

• A wide nasal tip naturally refined using septal extension with autologous rib cartilage

• Irregular nasal bridge refined into a smooth, straight bridge line

• Improvement of protruding mouth through nasolabial angle correction

1. Functional improvement

• Correction of deviated septum

• Nasal obstruction is expected to improve following hypertrophic rhinitis surgery

• Complete elimination of inflammation

2. Shape improvement

• Natural correction of the dorsal hump deformity

• Formation of a straight nasal bridge line

• Refinement of nasal tip definition

3. Structural stability

• Firm and sturdy septal reconstruction

• Improvement in nostril asymmetry through stable lower lateral cartilage reconstruction

• Significant improvement in breathing function is expected

Contracted noses resulting from Medpor extruding through the mucosa present a very high surgical complexity. Therefore, it is most appropriate to remove the material safely before full-scale contracture deformity develops.

The reasons why inflammation caused by Medpor extruding into the nasal interior carries a poor prognosis are as follows:

First, the normal cartilages surrounding the Medpor are frequently absorbed or destroyed by inflammation.

Second, because Medpor extrudes internally into the nasal cavity, early detection is difficult, often leaving the condition unattended for an extended period and worsening symptoms.

Third, once inflammation begins, it is difficult to control, making treatment complex.

Medpor is frequently discovered during revision surgeries for contracted noses, which is a direct consequence of these characteristics. For this reason, choosing safe materials and applying meticulous surgical technique are critical in rhinoplasty.

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

Thank you.

#closedrhinoplasty #revisionrhinoplasty #autologousribcartilage #contractednose #customrhinoplasty