Hello, I am Dr. Peter C. Kang.
Today, I would like to introduce the case of a patient who underwent revision rhinoplasty to address contracture and septal perforation that developed following a Gore-Tex rhinoplasty performed long ago.
Front, left profile, and oblique views during design consultation
Design consultation photos: front, right profile, and oblique views
📍 Surgical history
17 years ago: Gore-Tex nasal bridge, tip procedure, and alar reduction
3 to 5 years ago: Perforation closure and implant-free surgery
The patient's desired look
🔎 Initial consultation findings
Residual septal perforation
Nasal endoscopy photo showing septal perforation (+)
Loss of most of the septal cartilage
Severe nostril asymmetry
Deformity caused by contracture
Chronic rhinitis symptoms
Surgical goals
Resolve the remaining septal perforation
Septal reconstruction
Restore nostril symmetry
Improve contracture
Alleviation of rhinitis symptoms
💉 Surgical procedure details
Intraoperative findings
The septal perforation was significantly larger than what was visible on the surface
Septal cartilage damage was severe
Abundant contracted tissue was present, and the skin had limited elasticity
2. Reconstruction surgery
Performed septal perforation closure
Reconstructed the lost septal cartilage with autologous rib cartilage
Securing nostril symmetry
Removed contracted tissue as thoroughly as possible
3. Functional improvement
Treatment of rhinitis
Restoration of breathing function
Stabilization of the overall structure
✅ Surgical results
Before surgery / Day 0 immediately after surgery Photos taken immediately after surgery show swelling and may differ from the final result.
Functional improvement
Corrected septal perforation
Reconstructed septal cartilage
Improved breathing function
Before surgery / Day 0 immediately after surgery Photos taken immediately after surgery show swelling and may differ from the final result.
2. Aesthetic improvement
Correction of contracture deformity
Natural nasal line
Improved nostril symmetry
Before surgery / Day 0 immediately after surgery Photos taken immediately after surgery show swelling and may differ from the final result.
3. Overall changes
Securing a stable structure
Simultaneous functional and aesthetic improvement
Natural result
Before surgery / Day 0 immediately after surgery Photos taken immediately after surgery show swelling and may differ from the final result.
👨⚕️ Specialist's assessment
This case required resolving complex issues: contracture and septal perforation stemming from a Gore-Tex procedure performed long ago. Because almost no septal cartilage remained, septal reconstruction was the most critical objective. By successfully performing septal reconstruction alongside perforation closure, structural stability was established, and even the severe nostril asymmetry was improved, yielding a satisfying functional and aesthetic result.
This was Dr. Peter C. Kang. Thank you.
Front, oblique, and profile views on day 0 immediately after surgery. Photos taken immediately after surgery show swelling and may differ from the final result.
Nostril view on day 0 immediately after surgery. Photos taken immediately after surgery show swelling and may differ from the final result.
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Limitations and risks
When autologous rib cartilage is used, scarring and pain may remain at the donor site on the chest, and pneumothorax (pleural injury) can occur rarely. Over time, the grafted cartilage may warp or undergo partial resorption.
When revising after implant removal, contracture may progress again after removal, the nasal height and length may decrease, and staged surgery may be necessary depending on the skin condition.
When the septum is corrected at the same time, nasal obstruction may persist or recur, and in rare cases, septal perforation or changes in smell may occur.
Common potential risks include infection, bleeding, asymmetry, scarring, skin necrosis, and insufficient improvement; results vary depending on individual skin condition and previous surgical history.