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Septal damage and cartilage deficiency: evaluating residual structures in revision rhinoplasty

In cases documenting septal damage or cartilage deficiency, the scope of harvesting from previous surgeries and the structures remaining at this presentation are significant factors. In one patient, the deep and anterior portions of the septum were harvested as graft material in previous clinics, leaving almost none behind; another record describes an accompanying soft tissue defect inside the columella.

This collection distinguishes between a history of using the septum as surgical material and the current clinical finding of septal deficiency. While some cases also involve perforations, not all cartilage deficiencies are categorized as having a perforation. First check the remaining cartilage, surrounding tissues, and nasal tip support recorded in the original text, and compare how partial or total reconstructions were performed.

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Nasal reconstruction when almost no septum remains after two nose surgeries — Before-and-after comparison
Before-and-after comparison

Nasal reconstruction when almost no septum remains after two nose surgeries

This is a case of septal cartilage deficit, nasal bone asymmetry, and nasal obstruction remaining after two surgeries. Through a closed approach, autologous rib cartilage was used for septal reconstruction, along with nasolabial angle correction, nasal bone asymmetry correction, and radix adjustment.

Preoperative condition

Why noses deviate and bulbous tips persist after double jaw surgery, and how rib cartilage septal reconstruction is performed — Before-and-after comparison
Before-and-after comparison

Why noses deviate and bulbous tips persist after double jaw surgery, and how rib cartilage septal reconstruction is performed

This is a case of septal damage, a deviated nasal bridge, a bulbous nose, and nasal obstruction following double jaw surgery and two prior rhinoplasties. Autologous rib cartilage septal reconstruction, cartilage repositioning, lateral osteotomy, and functional nasal surgery were performed.

Preoperative condition

Why mesh remaining in the septum causes an upturned nose, and reconstruction after removal — Before-and-after comparison
Before-and-after comparison

Why mesh remaining in the septum causes an upturned nose, and reconstruction after removal

This is a case where mesh left in the septum after previous surgeries resulted in an upturned nose and excessive nostril show. All foreign material was removed, followed by septal reconstruction using autologous rib cartilage, replacement of the silicone implant, and reinforcement of the skin with acellular dermal matrix.

Preoperative condition

Why a nose becomes upturned and the columella retracts after repeated revisions, and how to reconstruct the septum — Before-and-after comparison
Before-and-after comparison

Why a nose becomes upturned and the columella retracts after repeated revisions, and how to reconstruct the septum

A case where damage from previous surgeries led to collapse of the anterior septum and nostril asymmetry. The septum was reconstructed using autologous rib cartilage, followed by nasal tip rhinoplasty with donor rib cartilage and implant replacement.

Preoperative condition

Why noses become short and upturned after multiple revision surgeries, and methods for reconstruction — Before-and-after comparison
Before-and-after comparison

Why noses become short and upturned after multiple revision surgeries, and methods for reconstruction

A case correcting an upturned nasal tip caused by loss of the septum from repeated revision surgeries. Autologous rib cartilage septal reconstruction, nasal mucosal advancement flap, silicone implant adjustment, and rhinitis surgery were performed concurrently.

Preoperative condition

Why rib cartilage reconstruction is needed when the septum is weak, even in primary rhinoplasty — Before-and-after comparison
Before-and-after comparison

Why rib cartilage reconstruction is needed when the septum is weak, even in primary rhinoplasty

A case of correcting a short, upturned nasal tip and a pinched nostril caused by congenital septal cartilage weakness. Autologous rib cartilage was used to reconstruct the septum and lower lateral cartilage, combined with lowering the nostril rim and lateral osteotomy.

Preoperative condition

Why a operated nose deviates and nostrils become asymmetric after physical trauma, and how septal reconstruction is performed — Before-and-after comparison
Before-and-after comparison

Why a operated nose deviates and nostrils become asymmetric after physical trauma, and how septal reconstruction is performed

A case where post-surgical trauma caused a septal tear, resulting in a crooked nose and nostril asymmetry. Septal reconstruction was performed using autologous rib cartilage, along with realigning the columellar central axis and replacing the implant.

Preoperative condition

Why a nose operated on twice looks long and drooping, and how septal reconstruction using rib cartilage is performed — Before-and-after comparison
Before-and-after comparison

Why a nose operated on twice looks long and drooping, and how septal reconstruction using rib cartilage is performed

A revision rhinoplasty case where the septum was depleted due to excessive cartilage use in prior surgeries. The septum was reconstructed using autologous rib cartilage, a cartilage fragment on the bridge was removed, and silicone implant replacement was combined with osteotomy.

Preoperative condition

Why the nasal tip deviates to one side after rhinoplasty and methods for reconstructing its support structure — Before-and-after comparison
Before-and-after comparison

Why the nasal tip deviates to one side after rhinoplasty and methods for reconstructing its support structure

Septal cartilage damaged from previous surgeries was reconstructed using autologous rib cartilage, and the lower lateral cartilages were restored. Lateral osteotomy and rhinitis surgery were performed concurrently to correct the crooked nose and nostril asymmetry.

Preoperative condition

Why the nose looks long and the nostrils look pinched after multiple rhinoplasties — Before-and-after comparison
Before-and-after comparison

Why the nose looks long and the nostrils look pinched after multiple rhinoplasties

Lost lower lateral cartilage was reconstructed using autologous rib cartilage, and asymmetric, pinched nostrils were corrected. By lowering the radix, the appearance of a long nose was reduced, and surgery for rhinitis and nasal valve stenosis was performed concurrently.

Preoperative condition

Why contracture remains in multiply operated noses: Reconstructing the columella and support framework — Before-and-after comparison
Before-and-after comparison

Why contracture remains in multiply operated noses: Reconstructing the columella and support framework

Contracture and septal defect resulting from repeated surgeries were reconstructed using autologous rib cartilage. For the retracted columella, retroauricular free skin flap grafting and perichondrium grafting were performed to restore its shape.

Preoperative condition

Why the nose looks short and the columella retracts after revision rhinoplasty, and how to reconstruct the septum — Before-and-after comparison
Before-and-after comparison

Why the nose looks short and the columella retracts after revision rhinoplasty, and how to reconstruct the septum

To correct septal cartilage loss from 3 prior surgeries, a short nose appearance, and a bulbous tip, the septum was reconstructed using autologous rib cartilage and the radix was lowered.

Preoperative condition

Why a multiply operated nose deviates and develops a widened tip, and how cartilage is reconstructed — Before-and-after comparison
Before-and-after comparison

Why a multiply operated nose deviates and develops a widened tip, and how cartilage is reconstructed

Following three prior procedures, a deviated nose caused by septal damage and a missing right lower lateral cartilage was restored through autologous rib cartilage structural reconstruction, silicone implant replacement, nasolabial angle correction, and rhinitis surgery.

Preoperative condition

Why the nasal bridge becomes uneven after rhinoplasty, and how septal reconstruction using rib cartilage is performed — Before-and-after comparison
Before-and-after comparison

Why the nasal bridge becomes uneven after rhinoplasty, and how septal reconstruction using rib cartilage is performed

An uneven nasal bridge, damaged septal cartilage, and nasal obstruction were corrected by removing the existing silicone implant and filler, followed by autologous rib cartilage reconstruction, re-insertion of a customized silicone implant, and septoplasty with inferior turbinoplasty.

Preoperative condition

Why a nose operated on multiple times continues to appear upturned, and how septal reconstruction is performed — Before-and-after comparison
Before-and-after comparison

Why a nose operated on multiple times continues to appear upturned, and how septal reconstruction is performed

Following previous surgeries and double-jaw surgery, an upturned nasal tip and nostril asymmetry were precisely corrected using donor rib cartilage septal reconstruction, lower lateral cartilage restoration, and a composite dermis-fat graft to the soft triangle.

Preoperative condition

Why the nasal tip turns upward and nasal obstruction occurs after multiple rhinoplasties: Autologous rib cartilage reconstruction — Before-and-after comparison
Before-and-after comparison

Why the nasal tip turns upward and nasal obstruction occurs after multiple rhinoplasties: Autologous rib cartilage reconstruction

To resolve a damaged septum, an upturned nasal tip, and rhinitis-related nasal obstruction after multiple surgeries, autologous rib cartilage septal reconstruction and inferior turbinate reduction were performed.

Preoperative condition

Why the nasal tip turns upward when the septum is lost, and how to reconstruct the septum with autologous rib cartilage — Before-and-after comparison
Before-and-after comparison

Why the nasal tip turns upward when the septum is lost, and how to reconstruct the septum with autologous rib cartilage

Septal support lost in previous surgeries was reconstructed with autologous rib cartilage, and pinched alae and depressed nasal bridge areas were reinforced to correct an upturned nasal tip and nostril show.

Preoperative condition

Why the columella retracts and the alar rim looks pinched after rhinoplasty, and how autologous rib cartilage reconstruction is performed — Before-and-after comparison
Before-and-after comparison

Why the columella retracts and the alar rim looks pinched after rhinoplasty, and how autologous rib cartilage reconstruction is performed

In a patient presenting with columellar retraction and a pinched right alar rim following rhinoplasty with silicone and donor rib cartilage, the existing materials were removed and reconstruction of the septum and alar cartilage was performed using autologous rib cartilage.

Preoperative condition

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Common questions before reading the cases

If septal cartilage was previously used, is it always classified as a severe defect?

We do not assume that. This section covers cases where a deficient or damaged state is explicitly documented in the original record. In one patient, it was recorded that different parts of the septum were harvested in prior surgeries, leaving almost nothing behind. A simple history of using the material and the clinical finding of the current remaining structure should be read as distinct pieces of information.

Does septal cartilage deficiency mean the same thing as a septal perforation?

In these materials, they are treated as separate topics. While some reconstruction records note that almost no cartilage remained, another patient had a 7×9 mm perforation explicitly documented alongside a damaged septum. Although both findings can coexist, the phrase cartilage deficiency alone does not conclude that a perforation exists. Please verify which condition was actually documented in the original text.

Related topics to explore

Insufficient tip supportSeptal perforationMultiple revision surgeriesSeptal reconstruction

Surgical records referenced in this guide

  • Revision rhinoplasty with autologous rib cartilage for a bulbous and drooping nose, along with columellar and nostril correction
  • How to reconstruct a columella retracted by contracture
  • Septal perforation and nasal tip cartilage show-through after repeated rhinoplasties: how reconstruction is performed
Original article

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