Contracture causing the nose to harden and shorten after previous surgery: why it occurs and how it is reconstructed

Hello, I am Dr. Peter C. Kang.

Today, I will introduce a case where a patient troubled by contracture and septal damage from previous surgery was reconstructed naturally using autologous rib cartilage with safety in mind.

Past history:

• 3 years ago: silicone implant + ear cartilage + septum + dorsal hump reduction + functional nasal surgery

Main concerns:

• Deformity caused by contracture

• Functional decline due to septal damage

• Widened and asymmetric nasal bones

• Retracted appearance of the left nostril

Special notes:

• Contracture and rhinitis following previous surgery

• Contracture resolution

• Natural nose

• Functional recovery

• Improvement of nostril asymmetry

1. Correction of contracted nose: implant and capsule removal

To resolve the stiffness caused by contracture, the previous implant and surrounding capsule were completely removed. Safe removal secured a clean structural foundation.

2. Functional restoration through septal reconstruction

The septum was severely damaged from the previous surgery. Septal reconstruction solidly rebuilt the central support and opened the obstructed airway, restoring breathing function.

3. Aligning nasal bones with lateral osteotomy

The widened and asymmetric nasal bones were precisely repositioned using lateral osteotomy. This established a symmetric, natural width on the front view.

4. Nasal bridge reconstruction with autologous rib cartilage

To minimize the risk of contracture, the nasal bridge was rebuilt using autologous rib cartilage. Because it is the patient's own tissue, there is no foreign body reaction, providing long-term stability.

5. Left nostril lowering

The retracted left nostril was lowered to improve symmetry. Balance on the front view was significantly enhanced.

• Contracture resolved through removal of implant and capsule

• Breathing function restored through septal reconstruction

• Widened and asymmetric nasal bones realigned with lateral osteotomy

• Natural nasal bridge achieved using autologous rib cartilage

• Asymmetry corrected by lowering the left nostril

• Overall natural and stable nasal structure achieved

This was a complex case requiring careful reconstruction of a nose deformed by contracture along with restoration of a severely damaged septum.

Treatment of a contracted nose:

Contracture is a serious complication arising from a foreign body reaction. Not only the implant but also the entire capsule must be removed to prevent recurrence. Reconstructing with autologous rib cartilage avoids foreign body reactions and provides a reliable solution.

The importance of septal reconstruction:

When the septum is damaged, support for the nasal tip weakens and breathing becomes difficult. Solidly restoring the central framework through reconstruction recovers both function and appearance.

Advantages of autologous rib cartilage:

Autologous rib cartilage provides sufficient strength and volume. The risk of contracture is minimal, and it resists resorption, offering long-term stability. It is a reliable choice in revision rhinoplasty.

Nasal bone repositioning:

Widened and asymmetric nasal bones can be corrected with lateral osteotomy. Precise repositioning establishes natural width and symmetry.

As a clinic specializing in revision rhinoplasty, we will continue to do our best to resolve serious complications such as contracture and deliver natural results. This has been Dr. Peter C. Kang, Medical Director. Thank you.

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