Why contracture and a crooked nose occur after repeated revision rhinoplasty, and how they are corrected

Hello, I am Dr. Peter C. Kang.

Today, I would like to share the case of a patient who came to improve contracture symptoms and a crooked nose that developed after multiple nasal surgeries.

• 6 to 7 years ago: Ear cartilage + silicone implant surgery (tip swelling, hardening, cartilage show-through)

• 5 years ago: Silicone implant replacement + additional ear cartilage + septal surgery (recurrence of contracture symptoms)

• 4 years ago: Silicone implant removal + autologous dermis (buttock) + autologous rib cartilage + alar reduction surgery

• 2 years ago: Revision surgery on the nasal tip only with autologous rib cartilage

• July-August of last year: nasal filler treatment for a low nasal bridge

1. Front view

• Deviated nose

• Broadened nasal bridge due to foreign material

• Bulbous nasal tip

• Alar asymmetry

• Nostril asymmetry (pinched left nostril)

2. Profile view

• High radix

• Bulbous and drooping nasal tip

• Acute nasolabial angle

• Protruding mouth findings

3. Nostrils

• Left nostril smaller than the right

• Nostril asymmetry

• Correction of deviated nose

• Lowering the upturned tip (primary request)

• Elevation of the nasal tip

• Preference for silicone implant use

1. Structural improvement

• Septal extension using autologous rib cartilage

• Correction of the left nostril narrowed after alar reduction

• Lateral repositioning of the ala

2. Shape improvement

• Correction of crooked nose

• Lowering the position of the nasal tip (top priority)

• Adequate elevation of tip height

• Slimming the broadened nasal bridge

3. Foreign material management

• Removal of existing foreign material

• Achieving balanced height using a silicone implant

• Improvement of protruding mouth through nasolabial angle correction

1. Front view

• Crooked nose correction

• Slimmer nasal bridge

• Correction of the pinched left nostril

• Restoration of the left ala

2. Profile view

• Natural radix position

• Adequately lowered nasal tip

• Improved nasolabial angle

• Correction of protruding mouth appearance by adjusting the nasolabial angle

3. Nostrils

• Asymmetric correction

• Enlargement of left nostril size

• Balanced overall structure

This case was complex, involving multiple prior surgeries and contracture symptoms. In particular, the left nostril, which had narrowed from previous alar reduction surgery, was improved by repositioning the ala laterally.

To fulfill the patient's primary request of 'lowering the upturned nose,' septal extension using autologous rib cartilage was performed to stably adjust the tip position while also securing adequate height. Using a silicone implant supplemented the height of the nasal bridge, achieving overall facial harmony.

Considering the patient's history of contracture symptoms, the surgery was performed with a focus on minimizing tissue tension, and detailed post-operative care instructions were provided to help maintain long-term stability.

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

Thank you.

#closedrhinoplasty #revisionrhinoplasty #contracturecorrection #crookednosecorrection #customrhinoplasty