Why a paranasal implant migrates into the nasal cavity causing breathing obstruction, and how to reconstruct it

Hello, I am Dr. Peter C. Kang.

Today, I will introduce a reconstruction case of a patient who suffered from breathing difficulties because an implant used in previous surgery obstructed the nasal cavity.

• 2010: Rhinoplasty + alar reduction + paranasal augmentation

• 2012: Septum + silicone implant + donor rib cartilage (DR) surgery

• 2013: Nasal valve + 3 functional nasal procedures

Severe functional issues

• State where the implant protruded into the right nasal cavity, blocking 2/3 of the airway

• Unable to breathe through the right side

• Rhinitis symptoms

Structural damage

• The septum was in very poor condition

• Retracted columella

• Severe damage to both lower lateral cartilages

• Pinched appearance of the alae

Aesthetic concerns

• Deviated nose

• Drooping tip

• Correction of deviated nose

• Desire to elevate the nasal tip

• Relief of internal nasal obstruction

Functional recovery

• Removal of the implant obstructing the nasal cavity

• Removal of the contralateral paranasal implant

Structural reconstruction

• Septal reconstruction using autologous rib cartilage

• Reconstruction of both lower lateral cartilages using autologous rib cartilage

• Restoration of retracted columella

Morphological improvement

• Correction of crooked nose

• Elevation of the drooping tip

• Improvement of the pinched appearance of the alae

• Correction of the nasolabial angle

Functional improvement

• Improvement of rhinitis through septoplasty and radiofrequency submucosal turbinoplasty of the inferior turbinates

Functional recovery

• The obstructed right nasal cavity was cleared

• Restoration of normal bilateral breathing function

• Alleviation of rhinitis symptoms

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 crooked nose

• Naturally restored alae

• Improvement of the pinched areas

• Balanced 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

• Naturally elevated nasal tip

• Restored columella

• Improved nasolabial angle

• Harmonious profile line

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

Structural stability

• Sturdy septal reconstruction

• Stable lower lateral cartilage structure

• Long-term stable outcome

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

This patient visited our clinic with a very unusual condition. Over time, an alar base implant placed in 2010 had migrated from its original position and protruded into the right nasal cavity, obstructing 2/3 of the nasal cavity. As a result, the patient was completely unable to breathe through the right side of the nose, experiencing significant daily discomfort and a severely reduced quality of life.

Migration of a paranasal implant is an uncommon complication, but it can occur over time due to changes in surrounding tissues or weakening of the implant's fixation. In this case, the displaced implant pushed into the nasal cavity, causing severe breathing obstruction.

At the same time, due to the nasal surgeries performed in 2012 and 2013, the septum was in very poor condition, and both lower lateral cartilages were severely damaged. The columella was retracted, and the alae appeared pinched, presenting multiple complex structural issues.

First and foremost, to restore breathing function, we removed the paranasal implant obstructing the nasal cavity. At the same time, we also removed the other paranasal implant to prevent similar issues from occurring in the future.

Next, to fundamentally rebuild the damaged nasal structure, we performed reconstruction using autologous rib cartilage. We completely reconstructed the septum to restore the central support structure of the nose, and also rebuilt the severely damaged bilateral lower lateral cartilages using autologous rib cartilage to correct the pinched alar appearance naturally. The retracted columella was restored as well.

Correction of the crooked nose and elevation of the nasal tip, which the patient desired, were also achieved during the structural reconstruction process. Correcting the nasolabial angle improved the harmony of the profile line as well.

As a result, we resolved the severe breathing obstruction caused by the migrated paranasal implant, and simultaneously corrected the structural damage from previous nasal surgeries through autologous rib cartilage reconstruction. In particular, using autologous tissue supports a stable long-term result.

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

Thank you.

#closedrhinoplasty #implantremoval #nasalobstruction #autologousribcartilagereconstruction #alarreconstruction #functionalrecovery