Why cartilage extrudes through the nasal mucosa and methods for restoration and reconstruction

Hello, I am Dr. Peter C. Kang.

Today, I would like to introduce the case of a patient in whom cartilage protruding through the right nasal mucosa from a previous surgery was restored and the damaged lower lateral cartilage was reconstructed.

Past history:

• 17 years ago: Silicone implant placed along the nasal bridge only

• 4 years ago: Donor rib cartilage + silicone implant + ear cartilage

Main concerns:

• A critical situation with cartilage protruding through the right nasal mucosa

• Severely damaged lower lateral (alar) cartilage

• A heavy, tired impression due to a drooping nasal tip

• Lack of three-dimensional definition due to a protruding mouth

• Nostril asymmetry

• Retracted columella

Special notes: Infection risk due to exposed cartilage; urgent surgery required

• Careful removal and restoration of the exposed cartilage

• Elevating the drooping nasal tip

• Improving the appearance of the protruding mouth to create a well-defined profile

• Improvement of nostril asymmetry

• Correction of a retracted columella

1. Removal of extruded cartilage and perichondrial grafting

The cartilage had penetrated through the right nasal mucosa, creating a dangerous situation. Because this could lead to infection or tissue necrosis, it was removed immediately, and the mucosal defect was restored with a perichondrial graft.

2. Reconstruction of the alar cartilage

The lower lateral cartilage had been severely damaged during previous surgery. By reconstructing it meticulously, a stable foundation was established to ensure the nasal tip shape remains well supported.

3. Correcting the drooping tip using autologous rib cartilage

A drooping nasal tip can make one look tired and older. Using autologous rib cartilage, the tip was elevated and defined to create a more youthful, refreshed impression.

4. Improving a protruding mouth through nasolabial angle correction

The patient lacked lateral facial projection due to a protruding mouth. By precisely adjusting the nasolabial angle, harmony between the nose and lips was achieved, resulting in a refined profile line. The retracted columella was also corrected, producing a distinct and defined contour.

5. Creating a natural nasal bridge line with a customized silicone implant

The existing silicone implant was removed, and a new implant was carved to fit the patient's underlying bone structure. This created a natural yet refined bridge line.

• Removal of extruded cartilage and mucosal repair using a perichondrial graft

• Reconstruction of the lower lateral cartilage to secure structural foundation

• Correction of the drooping tip with autologous rib cartilage, restoring a refreshed appearance

• Refinement of the nasolabial angle to improve the protruding mouth and enhance facial definition

• A natural nasal bridge created with a customized implant

• Improvement of nostril asymmetry

• An overall stable and natural outcome

This was a case requiring restoration from a hazardous state where cartilage had penetrated the mucosa, along with reconstruction of damaged lower lateral cartilage.

The severity of cartilage exposure:

Extrusion through the mucosa can lead to infection and tissue necrosis. The exposed cartilage must be removed immediately and repaired with a perichondrial graft.

The importance of alar cartilage reconstruction:

When the lower lateral cartilage is damaged, nasal tip support becomes unstable and asymmetry develops. Precise reconstruction creates a stable foundation.

The relationship between the nasolabial angle and a protruding mouth:

A protruding mouth often presents with an obtuse or poorly balanced angle, creating a heavy facial impression. Adjusting the nasolabial angle enhances three-dimensional facial balance and creates a refined appearance.

NOSELAB will continue to do its best as a revision rhinoplasty clinic dedicated to resolving complex structural complications and delivering natural results.

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

#closedrhinoplasty #closedrevisionrhinoplasty #cartilageexposurerepair #alarcartilagereconstruction #autologousribcartilage #nasolabialanglecorrection #protrudingmouthcorrection #nostrilasymmetrycorrection #revisionspecialist