Synthetic Dermal Graft Absorption – Revision Rhinoplasty to Correct Nasal Deformity

[Nose Lab Clinic]

Hello, this is Dr. Cha-Young Kang, Director of Nose Lab Clinic.

Today, I’ll share a case involving synthetic dermal graft absorption that caused nasal deformities. The patient underwent revision rhinoplasty to restore both function and appearance. This case highlights the limitations of certain graft materials and the importance of selecting stable, long-lasting solutions for nasal augmentation.

Design Consultation: Frontal View, Left Side View, and Oblique Side View Photos

Surgical History of the Patient

• 15 years ago: Silicone implant + septal cartilage (performed in Busan)

• 3 years ago: Donor dermis + ear cartilage + non-implant surgery

• 1 year ago: Donor dermis for nasal dorsum (minimal results due to synthetic dermal graft absorption)

Design Consultation: Right Side View, Oblique Side View, and Nostril View Photos

Problems Caused by Synthetic Dermal Graft Absorption

• Significant absorption of the synthetic dermis, reducing nasal dorsum height.

• Widening of the nasal bridge over time.

• Severe damage to the septal cartilage.

• Limitations of previous surgical techniques and materials identified.

Patient’s Goals for Revision Surgery

• Achieve a natural nasal line.

• Restore reduced nasal dorsum height.

• Preserve the existing nasal tip.

• Maintain subtle, natural-looking results without an overly noticeable appearance.

Surgical Approach to Correct Synthetic Dermal Graft Absorption

a. Problem Resolution

• Removed the absorbed synthetic dermal graft.

• Corrected the widened nasal bridge.

• Assessed and managed damaged septal cartilage.

b. Structural Reconstruction

• Reconstructed the septum using donor rib cartilage.

• Secured a stable support structure.

• Restored the height of the nasal dorsum.

c. Aesthetic Refinement

• Created a natural and seamless nasal line.

• Maintained harmony with the existing nasal tip.

• Adjusted overall nasal balance for improved proportions.

Surgical Outcomes and Aesthetic Improvements

Before (Left) / Immediately After (Right)

Frontal View

• Corrected the widened nasal bridge, established a smooth nasal line, and maintained natural width.

Before (Left) / Immediately After (Right)

Lateral View

• Achieved stable dorsal height and preserved tip harmony.

Before (Left) / Immediately After (Right)

Oblique View

• Improved projection and created a natural contour.

Before (Left) / Immediately After (Right)

Nasal Base View

• Corrected asymmetry and straightened the columella.

Expert Insights on Synthetic Dermal Graft Absorption

Immediately After Surgery: Frontal, Oblique Side, and Side View Photos

Immediately After Surgery: Nostril View Photos

This case underscores the limitations of synthetic dermal grafts in nasal surgery. Over time, absorption can lead to deformities, diminished projection, and patient dissatisfaction. To ensure stable, long-lasting results:

• Material Selection: Use biocompatible materials like autologous or donor rib cartilage.

• Surgical Technique: Precisely assess and manage structural weaknesses.

• Long-Term Stability: Prioritize methods that minimize future deformities.

This revision surgery demonstrates that with careful planning, both functional and aesthetic improvements can be achieved.

Nose Lab performs all surgeries through a closed approach.

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