Hello, I am Dr. Peter C. Kang.
Today, I would like to share the case of a patient who underwent autologous rib cartilage reconstruction to improve deformity, pain, and nasal obstruction caused by an old silicone implant.
Front, left profile, and oblique views during design consultation
Design consultation: right oblique, profile, and basal (nostril) views
📍 Surgical history
40 years ago: L-shaped silicone implant insertion
5 years ago: Surgery with septal cartilage and silicone implant
🔎 Primary symptoms
Right-sided nasal obstruction
Pressure-like pain on the nasal bridge
Nostril asymmetry
Columella deviated to the right
Upturned nose
High radix
✨ Patient's requests
Appropriate elevation
Improved nostril symmetry
Slender yet rounded nasal tip
Adjustment of radix position
Correction of crooked nose
💉 Surgical procedure details
Functional improvement
Septoplasty
Radiofrequency submucosal resection of the inferior turbinates
Septal reconstruction using autologous rib cartilage
2. Structural improvement
Correction of the deviated columella
Improvement of nostril asymmetry
Creation of a stable septal structure using autologous rib cartilage
3. Shape improvement
Stabilization of the upturned nose
Naturally lowering the radix at the glabella
Improvement of protruding mouth through nasolabial angle correction
✅ Surgical results
Function
Improvement of nasal obstruction
Relief of nasal bridge pain
Stable structure
Before surgery / Day 0 immediately after surgery Photos taken immediately after surgery show swelling and may differ from the final result.
2. Front view
Nostril symmetry
Natural height
Soft impression
Before surgery / Day 0 immediately after surgery Photos taken immediately after surgery show swelling and may differ from the final result.
3. Profile view
Lowered radix
Smooth profile line
Improvement of protruding mouth through nasolabial angle correction
Before surgery / Day 0 immediately after surgery Photos taken immediately after surgery show swelling and may differ from the final result.
4. Nostril view improvement
Correction of the columella deviated to the right
Correction of nostril asymmetry
Before surgery / Day 0 immediately after surgery Photos taken immediately after surgery show swelling and may differ from the final result.
👨⚕️ Specialist's assessment
Front, profile, and oblique views immediately after surgery on day 0 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.
In this case, the patient had endured deformity and pain from an L-shaped silicone implant over a long period of 40 years. Although the patient underwent implant replacement surgery 5 years ago, the pain persisted. At our clinic, septal reconstruction using autologous rib cartilage secured structural stability and improved the asymmetry of the columella and nostrils. In particular, straightening the columella, which had been tilted to the right, was the most notable outcome, achieving the slender yet rounded nasal tip the patient desired.
This was Dr. Peter C. Kang. Thank you.
Thank you.
#closedrhinoplasty #revisionrhinoplasty #autologousribcartilage #columellacorrection #customrhinoplasty
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.