Why the nasal tip turns upward and nostril show increases years after rhinoplasty: Medpor removal and autologous dermis reconstruction

Hello, I am Dr. Peter C. Kang.

Today, I would like to introduce the case of a patient who visited our clinic troubled by an upturned nose and nostril show 13 years after undergoing rhinoplasty.

• 13 years ago: surgery with ear cartilage and a silicone implant

• No functional issues experienced until recently

• Reducing excessive nostril show

• Correcting the upturned nose to achieve a natural angle

• Resolving nostril asymmetry

• Natural and reliable results planned with safety in mind

There was an important finding during surgery. Medpor had been used for septal extension in the previous surgery, and over the course of 13 years, severe adhesion to the surrounding tissues had developed.

The key to this surgery was the safe removal of Medpor and structural reconstruction using autologous tissue.

1. Safe removal of Medpor

• Removing the old Medpor without damaging surrounding tissues

• Meticulously dissecting the adhered areas

• Evaluating and debriding the septum after removal

2. Septal reconstruction using autologous dermis

• Using autologous dermis for a natural result planned with safety in mind

• Reinforcing nasal tip support through septal extension

• Structural reconstruction to improve the angle of the upturned nose

3. Correction of the nasolabial angle

• Adjusting the excessively upturned nasal tip angle

• Minimizing nostril show

• Creating a natural profile line

4. Concurrent functional nasal surgery

• Optimizing respiratory function through septoplasty

• Preventing nasal obstruction through inferior turbinate reduction

• Simultaneous cosmetic refinement and functional improvement

5. Asymmetry correction

• Balancing the size and shape of both nostrils

• Aligning the central axis of the nasal tip and columella

1. Correction of the upturned nose

• The excessively upturned nasal tip angle was adjusted to a natural position

• Nostril show was noticeably reduced

• The profile nasal line was refined gracefully

2. Correction of nostril asymmetry

• Symmetry in nostril size and shape was restored

• Overall facial balance on the front view was improved

3. Natural nasal contours

• A natural nasal shape without an artificial look

• The use of autologous dermis also improved the nasal feel to a natural texture

4. Functional improvement

• Breathing function improved concurrently

• Comfortable breathing without nasal obstruction

The most crucial aspect of this surgery was the safe removal of the Medpor placed 13 years prior. Over time, Medpor becomes densely incorporated into surrounding tissues, requiring meticulous care during dissection.

Revision rhinoplasty for surgery performed long ago is far more complex and challenging than standard primary procedures. One must navigate pre-existing scar tissue and altered anatomical structures, and an even more cautious approach is needed when synthetic materials such as Medpor are involved.

In this type of case, safely removing the Medpor and reconstructing the septum with autologous dermis made it possible to achieve long-term, stable, and natural results. Because autologous dermis is the patient's own tissue, the risk of rejection or complications is minimal, and it maintains a natural appearance over time.

When correcting an upturned nose, simply adjusting the angle is not enough; securing structural support via septal extension is essential. This allowed us to satisfy both goals requested by the patient: minimizing nostril show and achieving a natural nasal shape.

I am pleased that the concerns that troubled the patient for 13 long years were addressed through this surgery. We will continue to provide post-operative follow-up to support and preserve the intended result.

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

#closedrhinoplasty #closedrevisionrhinoplasty #upturnednosecorrection #medporremoval #autologousdermisrhinoplasty #nostrilasymmetry #functionalnasalsurgery #septalreconstruction