Why nasal tip support weakens in an aged implant nose and septal extension reconstruction methods

Hello, I am Dr. Peter C. Kang.

Today, I would like to introduce a rhinoplasty case of a patient who traveled to our clinic from overseas. In this case, we replaced the existing silicone implant and performed septal extension using autologous rib cartilage to achieve a more natural and stable nasal line.

• 8 years ago: surgery with silicone implant and ear cartilage

The patient had previously undergone rhinoplasty with a silicone implant at another clinic. Over time, however, the patient felt that the contour of the implant looked unnatural and had concerns that the structural support of the nasal tip had weakened.

Main requests:

• Replacement of the existing silicone implant

• Improvement of nasal tip height and structural support

• Formation of a natural bridge line

• Long-term stable outcome

1. Removal and replacement of the existing silicone implant

After safely removing the existing implant, a new silicone implant was customized and inserted to suit the patient's nasal framework and skin condition. The implant was meticulously carved and prepared, taking into account the patient's facial proportions and desired bridge height.

2. Septal extension using autologous rib cartilage

To fundamentally reinforce structural support at the nasal tip, autologous rib cartilage was harvested and septal extension was performed.

Advantages of autologous rib cartilage:

• No tissue rejection because it is autologous tissue

• Maintaining tip shape with firm structural support

• Long-term stable outcome

• Minimizing the risk of contracture

By extending the septum downward, the height and shape of the nasal tip were naturally improved.

3. Tip plasty

An additional cartilage graft was placed over the extended septum to complete a refined yet natural nasal tip. The shape and projection of the tip were determined considering the overall balance of the patient's face.

Front view changes:

• Nasal bridge line became more natural and smooth

• Nasal tip repositioned to an appropriate height

• Improved overall nasal balance

Profile view changes:

• Nasal bridge connects with a natural curve

• Nasal tip is appropriately elevated to form a refined line

• Natural improvement of the nasolabial angle (angle between nose and upper lip)

Nostril view changes:

• Maintaining stable shape by reinforcing tip support

• Nostril shape naturally refined

In revision rhinoplasty, replacing an existing implant while simultaneously providing structural reinforcement with autologous tissue is a very important approach. In particular, when previous surgery was performed using only synthetic implants, the surrounding tissues can weaken or contracture can occur over time.

In this surgery, structural support of the nasal tip was fundamentally reinforced through septal extension using autologous rib cartilage. Autologous tissue maintains its shape over time, and when used alongside a synthetic implant, it supports more stable and natural long-term results.

As this patient chose NOSELAB from overseas, the surgery was performed meticulously to achieve the intended outcome. I hope this serves as helpful information for those with similar concerns. This has been Medical Director Dr. Peter C. Kang. Thank you.

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