Why a wide nasal bridge and upturned nasal tip develop, and how rib cartilage reconstruction is performed

Hello, I am Dr. Peter C. Kang.

Today, I would like to share a case of a patient who improved a wide nasal bridge and an upturned nose through reconstruction using donor rib cartilage.

• 10 years ago: Ear cartilage + silicone implant surgery

• 2 months later: Silicone implant removed due to foreign body reaction (feeling of fluid accumulation)

• 5 years ago: Silicone implant + septal cartilage surgery

• 3 years ago: Silicone implant + donor rib cartilage surgery

• Nasal bridge thread procedure: Foreign body reaction on the nasal bridge

• 6 months ago: Total removal + autologous rib cartilage reconstruction

• Right-sided nasal obstruction

• Nasal bridge appearing wide

• Upturned nasal tip

• Elevated nasal bridge findings observed on CT

• Improvement of wide-looking nasal bridge

• Correction of upturned nose

• Patient did not want to use a silicone implant

• Preference for donor rib cartilage

1. Detailed examination and foreign material removal

• Assessment of nasal bridge condition via CT

• Complete removal of remaining threads and filler

2. Improvement of wide nasal bridge

• Lateral osteotomy performed

• Creation of a balanced nasal bridge width

• Adjustment of nasal bridge height using donor rib cartilage

3. Improvement of upturned nose

• Adjustment of nasal tip height taking into account the stretchability of the nasal tip skin

• Maximizing recycling of existing autologous rib cartilage

• Supplementing deficient areas with donor rib cartilage

• Performing septal reconstruction

1. Front view

• Slimmer nasal bridge line

• Balanced width

• Natural symmetry

2. Profile view

• Stable tip position

• Improved upturned nose

• Harmonious height and nasal bridge line

3. Function

• Improvement of nasal obstruction

• Stable septal condition

• Reduced risk of foreign body reaction

This case involved revision rhinoplasty performed due to repeated foreign body reactions and complications from nasal bridge thread procedures. When foreign materials were suspected on the nasal bridge during the CT scan, both threads and filler were confirmed and completely removed during surgery, with primary focus placed on correcting the upturned nasal tip. The tip height was adjusted appropriately considering that the patient's nasal tip skin did not stretch easily, and the wide nasal bridge was narrowed through lateral osteotomy.

Because there was severe damage to the septal cartilage, the autologous rib cartilage used in the previous surgery was recycled as much as possible, and deficient areas were supplemented with donor rib cartilage to secure a stable framework.

Since the patient preferred not to use a silicone implant or undergo harvesting of additional autologous rib cartilage, donor rib cartilage was used for the nasal bridge, also taking into account the past history of repeated foreign body reactions.

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

Thank you.

#closedrhinoplasty #revisionrhinoplasty #upturnednosecorrection #donorribcartilage #customrhinoplasty