Chronic foreign body reaction causing a blunt, widened nasal bridge: causes and reconstruction methods

Hello, I am Dr. Peter C. Kang.

Today, I would like to introduce a case of a patient whose chronic foreign body reaction and septal damage from prior double jaw surgery were reconstructed using autologous rib cartilage.

• 15 years ago: Double jaw surgery

• 10 years ago: Nasal filler injection (subsequently dissolved)

• 10 years ago: Alar elevation

• 2 years ago: Rhinoplasty with donor rib cartilage and silicone implant

1. Front view

• Broad nasal bridge

• Blunt shape

• Excessive nostril show

• Nostril asymmetry

2. Profile view

• High radix starting point

• Upturned appearance

• Awkward columella-to-bridge line

3. Oblique view

• Protruding mouth findings

• Overall blunt shape

4. Nostril view

• Nostril asymmetry

• Columella tilted to the left

• Correction of upturned nose

• Correction of the nasolabial angle

• Natural result

• Non-pointed shape

1. Management of foreign body reaction

• Discovery of serous fluid caused by a chronic foreign body reaction in the nasal bridge

• Bacterial culture and antibiotic sensitivity testing requested

• Irrigation and capsule removal

2. Structural reconstruction

• Identification of septal damage from double jaw surgery

• Septal reconstruction using autologous rib cartilage

• Stabilization of the overall structure

3. Shape improvement

• Correction of the nasolabial angle

• Improvement in excessive nostril show

• Creation of a natural columellar line

1. Front view

• Slimmer nasal bridge

• Improved bulbous appearance

• Reduced nostril show

2. Profile view

• Natural radix starting point

• Stable columella-to-bridge transition

• Improved upturned appearance

3. Nasolabial angle

• Corrected nasolabial angle

• Improved protruding mouth

• Harmonious overall shape

This was a notable case with unexpected findings during surgery. The nasal bridge, which initially appeared blunt and widened, turned out to be swollen due to a chronic foreign body reaction. After irrigation and capsule removal, the true condition could be properly assessed.

Additionally, severe damage to the septal cartilage from double jaw surgery 15 years prior made septal reconstruction using autologous rib cartilage essential. Through this, structural stability was secured, and correction of the upturned nose and a natural nasolabial angle desired by the patient were achieved together.

Because there is a risk of postoperative inflammation, intravenous antibiotic therapy may be required, making continuous follow-up care crucial in this case.

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

Thank you.

#closedrhinoplasty #revisionrhinoplasty #foreignbodyreaction #septalreconstruction #customrhinoplasty