Why foreign material from illicit injections remains after removal and how to correct an upturned nasal tip

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

Today, I would like to introduce a case where foreign material and an upturned nose resulting from illicit nasal filler injections 15 years ago were corrected.

• 15 years ago: Illicit injection procedure

• 15 years ago: Surgery with silicone implant + septal cartilage + foreign material removal

• 2 weeks later: Additional surgery with artificial dermis on the nasal bridge

Front view

• Upturned nasal shape

• Excessive nostril show

• Flat and spread appearance

Profile view

• High radix

• Protruding mouth

• Nasolabial angle issue

Nostrils

• Nostril asymmetry

• The columella tilts to the left

• Reduction in nostril show

• Lowering the glabella height

• Desire to raise the nasal tip

Complete removal of foreign material

• Completely removing the remaining illicit injection material that was thought to have been removed during previous surgery

Structural improvement

• Tip plasty using autologous rib cartilage

• Correction of upturned nose

• Reduction of nostril show

• Correction of columella position

Morphological improvement

• Adjustment of high radix

• Improvement of the flat and spread appearance

• Correction of the nasolabial angle

• Improvement of nostril asymmetry

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

Front view

• Improvement in upturned nasal shape

• Significantly reduced nostril show

• More natural nasal shape

• Improved nostril symmetry

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

Profile view

• Properly adjusted radix

• Improved protruding mouth

• Natural nasolabial angle

• Balanced profile line

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

Nostrils

• Corrected columella position

• Improved nostril symmetry

• Natural nostril shape

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

This case involved resolving both the complications from illicit injections performed 15 years ago and an upturned nose. Illicit injections use non-medical substances and are very dangerous procedures that can lead to various side effects and foreign body reactions over time.

The patient recognized the problem soon after the illicit injection 15 years ago and underwent nasal surgery along with foreign material removal, but the illicit material that was supposed to have been removed in the previous surgery still remained. The patient's biggest concern was that significant nostril show persisted due to the upturned shape of the nose.

On the front view, the upturned nose caused excessive nostril show, giving an overall flat and spread appearance. On the profile view, the radix was excessively high, looking unnatural, and a protruding mouth was also evident. When inspecting the nostrils, asymmetry was present, and the columella was tilted to the left.

Although the patient was told the foreign material had been removed during the previous surgery, the illicit injection substance actually remained. Such illicit injection materials are often difficult to clear completely and can persist even through multiple operations. During this surgery, the remaining foreign material was meticulously located and completely removed.

To correct the upturned nose, nasal tip rhinoplasty was performed using autologous rib cartilage. The excessively visible nostrils were naturally reduced, and the nasal tip was appropriately elevated according to the patient's preferences, creating a well-balanced shape.

The high radix was properly adjusted to lower the height between the eyebrows, creating a natural profile line. The nasolabial angle was also corrected to improve the appearance of the protruding mouth.

The leftward tilt of the columella and nostril asymmetry were also improved through structural correction. The flat, spread nasal shape was transformed into a natural, defined contour.

This was a meaningful case in which the complications of the illicit injection were thoroughly addressed while concurrently correcting the upturned nose and nostril show, achieving the natural, balanced nasal shape the patient desired. Completely removing the remaining foreign material that had been left behind in previous surgery allowed for a more reliable and natural outcome.

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

Thank you.

#closedrhinoplasty #illicitinjectionremoval #upturnednosecorrection #nostrilshowreduction #foreignmaterialremoval #customrhinoplasty