How the nose changes when donor rib cartilage is resorbed, and how autologous rib cartilage reconstruction is performed

Hello, I am Dr. Peter C. Kang.

Today, I will introduce a case where various issues caused by donor rib cartilage resorption and scar tissue were resolved through autologous rib cartilage reconstruction.

• First: Use of donor rib cartilage → Development of inflammation

• 2018: Surgery using silicone implant + ear cartilage + donor rib cartilage

Problems caused by donor rib cartilage resorption

• Nasal tip became smaller

• Nose became short again

Structural concerns

• Both alae appear pinched

• Nasal tip appears drooping

• Excessive nostril show

• Nostril asymmetry

• Upturned appearance due to an increased nasolabial angle

Skin issues

• Uneven surface on the nasal bridge due to scar tissue

• Resolving problems caused by donor rib cartilage resorption

• Correction of pinched alae

• Improvement in irregular nasal bridge

• Natural nasal shape

Structural reconstruction

• Septal extension using autologous rib cartilage

• Reconstruction of both lower lateral cartilages with autologous rib cartilage

• Correction of pinched alae

• Correction of the nasolabial angle

Surface improvement

• Smoothing the uneven nasal bridge with cartilage and a dermal graft

• Refining the irregular surface caused by scar tissue

Overall shape improvement

• Enlarging the shrunken nasal tip

• Lengthening the shortened nose

• Improvement of a drooping tip

• Correcting the upturned appearance

Front view

• Pinched alae naturally improved

• Nasal tip restored to an appropriate size

• Balanced nostril shape

• Smoothed bridge surface

Profile view

• Restored nasal length

• Improved tip position

• Appropriate nasolabial angle

• Improvement in the upturned appearance

Overall

• Natural nasal shape

• Harmonious overall proportions

• Stable structure

In this case, the patient had experienced inflammation after using donor rib cartilage and underwent revision rhinoplasty including donor rib cartilage; over time, shape deformities developed due to the resorption of the donor rib cartilage.

The primary issue was that the nasal tip had shrunk and the nose had shortened again due to donor rib cartilage resorption. In addition, the alae appeared pinched on both sides, excessive nostril show was present, and asymmetry had developed. On the nasal bridge, scar tissue from previous surgeries remained, creating an uneven surface.

To address these complex issues, I chose a comprehensive reconstructive approach using autologous rib cartilage. First, I reconstructed both lower lateral cartilages with autologous rib cartilage to naturally improve the pinched appearance of the alae. Unlike donor rib cartilage, autologous rib cartilage has minimal resorption and supports a stable result over the long term, making it the most critical choice for this reconstruction.

The shrunken nasal tip was addressed through septal extension using autologous rib cartilage, which also allowed us to restore the length of the nose. The upturned appearance caused by a drooping tip and an increased nasolabial angle was also effectively improved through nasolabial angle correction.

In particular, the uneven area on the nasal bridge was smoothed out into a natural contour by combining cartilage and a dermal graft. This was an issue that could not easily be resolved with an implant alone, requiring a customized approach tailored to the patient's tissues.

As a result, the various problems caused by donor rib cartilage resorption were fundamentally resolved through autologous rib cartilage reconstruction, achieving an overall natural and balanced nasal shape. Furthermore, using autologous rib cartilage secured long-term stability, so the patient can expect to maintain a consistently satisfying result.

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

Thank you.

#closedrhinoplasty #donorribcartilageresorption #autologousribcartilagereconstruction #alarreconstruction #customrhinoplasty