Why Medpor causes loss of the anterior septum: removal and autologous rib cartilage reconstruction

Hello, I am Dr. Peter C. Kang.

Today, I would like to share the case of a patient who visited our clinic with a nose that had become crooked, drooping, and markedly asymmetrical due to Medpor and Gore-Tex used in a previous surgery. During surgery, examination revealed that the septal cartilage was severely damaged, with almost none of the anterior portion remaining.

• Previous rhinoplasty using Medpor and Gore-Tex

• Correction of a crooked and drooping nasal tip

• Improvement of nostril asymmetry

• Improvement in the overall nasal line

• Relief of severe nasal obstruction

• Correction of a receding chin

1. Complete removal of Medpor

• Thorough removal of Medpor found during surgery

• Debridement of tissues damaged by Medpor

• Confirmation of near-total loss of the anterior septal cartilage

Removed Medpor (top), removed Gore-Tex (bottom)

2. Gore-Tex removal and silicone implant replacement

• Removal of Gore-Tex used on the nasal bridge

• Replacement with a stable silicone implant

• Formation of a natural bridge line

3. Septal reconstruction using autologous rib cartilage

• Reconstruction of the damaged, virtually absent anterior septum

• Creating a sturdy support structure with autologous rib cartilage

• Resolving the underlying cause of the crooked and drooping nasal tip

4. Nasal tip asymmetry correction

• Repositioning the nasal tip based on the reconstructed septum

• Improvement of nostril asymmetry

• Achieving a balanced nasal tip shape

5. Nasal sill reduction

• Bringing in a wide-appearing nasal floor

• Adjusting the overall nasal width

6. Deviated septum and rhinitis surgery

• Relief of severe nasal obstruction

• Correction of the deviated septum

• Restoration of breathing function through rhinitis surgery

7. Receding chin correction

• Correction of the retruded chin point

• Enhancing overall facial balance

• Harmonious profile line between the nose and chin

1. Frontal changes

• The crooked nose was aligned along the midline

• Improvement of nostril asymmetry

• Overall refined impression as the nasal floor is narrowed

2. Profile changes

• The drooping tip was naturally elevated

• Balanced profile line achieved through receding chin correction

• Harmonious balance between the nose and chin

3. Nostril changes

• Improvement of nostril asymmetry

• Balanced nostril shape following nasal sill reduction

This was a case where Medpor severely damaged the septal cartilage, resulting in a nasal tip that was crooked, drooping, and asymmetrical. During surgery, intraoperative findings confirmed that almost no anterior septum remained, leaving no supporting structure for the nasal tip.

Medpor is a porous biomaterial into which tissue ingrowth occurs, making it difficult to remove and capable of damaging surrounding tissues. In this operation, the Medpor was thoroughly removed, and the Gore-Tex on the nasal bridge was also removed and replaced with a stable silicone implant.

The most crucial step was reconstructing the damaged septum. Using autologous rib cartilage, the lost anterior septum was newly recreated, and on this foundation, the crooked, drooping nasal tip was realigned. Proper reconstruction of the septum is essential for the nasal tip shape to remain stable over the long term.

Because the patient also suffered from severe nasal obstruction, deviated septum correction and rhinitis surgery were performed concurrently to improve respiratory function. Additionally, since severe chin retrusion meant that correcting the nose alone could leave the facial profile unbalanced, receding chin surgery was also performed. Harmonizing the relationship between the nose and chin is necessary to complete a balanced profile.

I hope this case provides helpful insight for those struggling with nasal deformities after previous surgeries using materials such as Medpor or Gore-Tex.

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

#closedrhinoplasty #closedrevisionrhinoplasty #medporremoval #goretexremoval #septalreconstruction #autologousribcartilage #recedingchincorrection #deviatedseptum #nasalobstruction