Why the alae become pinched and the tip collapses after nasal tip inflammation, and methods for reconstruction

Hello, I am Dr. Peter C. Kang.

Today, I would like to introduce the case of a patient who improved nasal tip inflammation and a pinched ala that developed after multiple surgeries.

• 2017: Septal cartilage + silicone implant surgery

• 2020: Silicone implant + autologous rib cartilage surgery

• December 2023: Surgery with silicone implant and autologous rib cartilage (harvested anew)

• 3 months later: Incision and drainage due to nasal tip redness and swelling

• Same day: Irrigation and implant removal

• April 2024: Scar injection treatment

• August 2024: First reconstruction surgery at our clinic (autologous rib cartilage + silicone implant + skin graft + septal reconstruction + alar rim graft)

• Improvement of the right alar pinching

• Elevation of the nasal tip

• Improvement of the nasal tip skin depression

• Correction of the overall nasal shape

• Relief of the foreign body sensation inside the nose

• Improvement of the columellar color (bruise-like appearance)

1. Nasal tip improvement

• Tip correction using autologous rib cartilage

• Increasing height while simultaneously adjusting to a stable position

• Skin and dermal graft reinforcement to improve columellar color

2. Alar correction

• Improvement of pinching through right nostril elongation

• Improvement in nostril shape

• Achieving overall symmetry

3. Improvement of internal structure

• Correction of irregular areas in the nasal cavity mucosa

• Removal of the cause of the foreign body sensation

• Formation of a stable internal structure

1. Front view

• Correction of upturned nose

• Improved alar pinching

• Balanced overall shape

• Natural nasal tip height

2. Profile view

• Adequately elevated nasal tip

• Harmonious straight bridge line

• Stable structure

3. Nostrils

• Correction of the pinched right nostril

• Improvement in nostril symmetry

• Improvement of the nasal tip skin depression

• Balanced nostril shape

This was a case of improving nasal tip inflammation and the resulting structural changes after multiple surgeries. Improvement was needed across several aspects, particularly the pinching of the right ala, tip height, and columellar color.

Through septal reconstruction using autologous rib cartilage, alar reconstruction, and tip correction with a skin graft, we secured a stable framework while achieving the desired height. In addition, right nostril elongation naturally improved the pinched ala, and correcting the irregular mucosa inside the nasal cavity resolved the foreign body sensation.

By focusing on structural stability to help prevent recurrent inflammation, we were able to achieve functionally satisfying results as well.

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

Thank you.

#closedrhinoplasty #revisionrhinoplasty #pinchednosecorrection #autologousribcartilage #customrhinoplasty