Hello, I am Dr. Peter C. Kang.
Today, I will share the case of a patient whose postoperative nostril asymmetry and drooping tip were improved using autologous rib cartilage.
Front, left profile, and oblique views during design consultation
📍 Surgical history
15 years ago: Surgery with a silicone implant, septal cartilage, and ear cartilage
10 years ago: Implant-free surgery with donor rib cartilage
🔎 Initial consultation findings
Front view
Nostril asymmetry
Excessive nostril show
Flared nasal shape
Design consultation: right oblique, profile, and basal (nostril) views
2. Profile view
Retracted columella
Irregular nasal bridge
Drooping tip
Overall disharmony
3. Special notes
Scar on the right columella
Septum deviated to the left
Weakened septal cartilage
Left-sided nasal obstruction
Nasal endoscopy photo
✨ Patient's requests
Improvement of nostril asymmetry
Improvement in excessive nostril show
Lowering the columella and correcting the nasolabial angle
Natural result
Refusal of silicone implant use
💉 Surgical procedure details
Structural reinforcement
Confirmed a weakened septum due to excessive septal cartilage harvesting during previous surgery
Reinforcing the septum using autologous rib cartilage
Correction of the left-deviated septum
2. Shape improvement
Correcting a wide nose with lateral osteotomy
Shaping the nasal bridge using autologous rib cartilage
Lowering the columella
3. Detailed adjustments
Diced cartilage and dermis grafting for the uneven nasal dorsum
Correction of the nasolabial angle
Improvement of the right columellar scar
✅ Surgical results
Before surgery / Day 0 immediately after surgery Photos taken immediately after surgery show swelling and may differ from the final result.
Front view
Improved nostril symmetry
Reduced nostril show
Slimmer nasal lines
Improvement of crooked nose
Before surgery / Day 0 immediately after surgery Photos taken immediately after surgery show swelling and may differ from the final result.
2. Profile view
An appropriately lowered columella
Smooth dorsal line
Correction of the nasolabial angle
Correction of the drooping tip
Natural overall proportions
Before surgery / Day 0 immediately after surgery Photos taken immediately after surgery show swelling and may differ from the final result.
3. Function
Strengthened septal structure
Improvement of nasal obstruction
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 type of case, the main issues were structural weakening and asymmetry caused by excessive harvesting of septal cartilage during prior surgeries. Autologous rib cartilage was used to securely reinforce the weakened septum, and lateral osteotomy was performed to correct the widened nasal framework.
In particular, diced cartilage and dermis were grafted onto the uneven bridge to create a smooth contour. As requested by the patient, a natural result was achieved without using any silicone implants. By lowering the columella and improving nostril asymmetry, an overall harmonious nasal shape was completed.
This was Dr. Peter C. Kang. Thank you.
Thank you.
#closedrhinoplasty #revisionrhinoplasty #autologousribcartilage #nostrilcorrection #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 using donor rib cartilage, long-term follow-up is necessary because the grafted cartilage may resorb or warp.
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.