[Nose Lab Clinic]
Hello, this is Dr. Cha-Young Kang, Director of Nose Lab Clinic.
Today, I’ll share a case involving a patient who underwent revision surgery to address nasal deformities caused by the absorption of a synthetic dermal graft. 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
1. Surgical History
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 absorption)
Design Consultation: Right Side View, Oblique Side View, and Nostril View Photos
2. Problem Analysis
Significant absorption of the synthetic dermis, leading to a reduced nasal dorsum height.
Widening of the nasal bridge over time.
Severe damage to the septal cartilage.
Limitations of previous surgical techniques and materials identified.
3. Patient’s Goals
Achieve a natural nasal line.
Restore the reduced nasal dorsum height.
Preserve the existing nasal tip.
Maintain subtle, natural-looking results without an overly noticeable appearance.
4. Surgical Approach
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 the overall nasal balance for improved proportions.
5. Surgical Outcomes and Significance
Before (Left) / Immediately After (Right)
a. Frontal View
Corrected the widened nasal bridge.
Established a smooth, uniform nasal line.
Maintained a natural width for the nasal dorsum.
Before (Left) / Immediately After (Right)
b. Lateral View
Achieved stable nasal dorsum height.
Maintained consistent dorsal contour.
Preserved harmony with the existing nasal tip.
Before (Left) / Immediately After (Right)
c. Oblique View
Improved nasal projection and depth.
Created a natural, aesthetically pleasing line.
Before (Left) / Immediately After (Right)
d. Nasal Base View
Corrected nasal asymmetry.
Straightened the deviated columella.
6. Expert Insights
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, the absorption of such materials can lead to deformities, diminished projection, and patient dissatisfaction. To ensure stable, long-lasting results, the following principles are critical:
Material Selection: Use of robust, biocompatible materials like autologous or donor rib cartilage.
Surgical Technique: Precise assessment and management of structural weaknesses.
Long-Term Stability: Prioritize methods that minimize the risk of future deformities.
This case demonstrates the transformative potential of a carefully planned revision surgery, with both functional and aesthetic outcomes achieved.
Thank you for reading, and I hope this example offers valuable insights for anyone considering or managing nasal surgery.
Dr. Cha-Young Kang
Director, Nose Lab Clinic
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