Why rib cartilage calcification must be evaluated in advance and correction methods for crooked and short noses

Hello, this is Dr. Peter C. Kang, medical director.

Today, I would like to introduce a case where a crooked nose, a short nose, and excessive nostril show were corrected using autologous rib cartilage.

• 15 years ago: silicone implant + ear cartilage surgery

Functional issues

• Rhinitis symptoms

Front view

• Deviated nose

• Excessive nostril show

• Bulbous nasal shape

Profile view

• Short nose

• Upturned nose

• Drooping nasal tip

• High radix

• Correction of crooked nose

• Improving the length of a short nose

• Improvement of drooping tip

• Correction of upturned nose

• Lowering the glabella radix

• Improving a blunt tip shape

Special notes

• Partial calcification of autologous rib cartilage confirmed on preoperative chest X-ray

• Selective harvest of the right 8th rib cartilage with minimal calcification

Structural improvement

• Reinforcing nasal framework using autologous rib cartilage

• Repositioning nasal framework to correct a crooked nose

• Septal extension to lengthen a short nose

• Alar lowering performed to improve excessive nostril show

• Concurrent surgery to improve rhinitis

Improvement in shape

• Lowered glabella radix

• Correction of upturned nose

• Improvement of bulbous nasal tip

• Nasal lengthening

Functional improvement

• Inferior turbinates reduced

• Rhinitis symptoms expected to be relieved

Before surgery / Day 0 immediately after surgery Photos taken immediately after surgery show swelling and may differ from the final result.

Front view

• Correction of deviated nose

• Reduction of nostril show

• Natural nasal shape

Before surgery / Day 0 immediately after surgery Photos taken immediately after surgery show swelling and may differ from the final result.

Profile view

• Appropriately lengthened nasal length

• Improvement of upturned nose

• Correction of a drooping tip

• Lowered glabella radix

• Improved nasolabial angle

Before surgery / Day 0 immediately after surgery Photos taken immediately after surgery show swelling and may differ from the final result.

Nostrils

• Improvement of nostril asymmetry

• Balanced nostril shape

Before surgery / Day 0 immediately after surgery Photos taken immediately after surgery show swelling and may differ from the final result.

This patient had undergone surgery with a silicone implant and ear cartilage 15 years ago, and presented with complex concerns including a crooked nose, short nose, drooping tip, upturned nose, and excessive nostril show.

A particularly notable aspect of this case was that calcification of the autologous rib cartilage was observed on preoperative chest X-rays, leading to the selective harvest of the right 8th rib cartilage, which showed the least progression of calcification. This was a critical step in supporting a stable result over the long term. Harvesting rib cartilage with progressive calcification carries the risk of complications such as pneumothorax, and in severe cases of calcification, cartilage harvesting may not be possible. Therefore, it is essential to check the degree of calcification in advance and plan the surgery with safety in mind.

The crooked nose was corrected through structural reconstruction using autologous rib cartilage, and septal extension was performed to correct the short nose and drooping tip. In particular, excessive nostril show was addressed through alar lowering, effectively minimizing visible nostrils from the front view.

In addition, the upturned nasal shape and high radix starting point were naturally refined through meticulous adjustments to the nasal structures, and the blunt nasal tip was reshaped with greater definition to establish a harmonious nasal line. For the patient's rhinitis symptoms, a functional procedure was performed concurrently to improve respiratory airflow.

Through the selective harvest of autologous rib cartilage with minimal calcification and a comprehensive approach to complex nasal problems, we were able to address the patient's concerns while supporting a stable result over time.

This has been Dr. Peter C. Kang, medical director.

Thank you.

#closedrhinoplasty #crookednosecorrection #shortnosecorrection #autologousribcartilage #customrhinoplasty