Autologous Rib Cartilage Reconstruction – Journey to a Natural Nose After Six Surgeries

Autologous Rib Cartilage Reconstruction – Journey to a Natural Nose After Six Surgeries

Hello, I’m Dr. Cha-Young Kang, Director of NoseLab Clinic.

This case highlights a patient who endured multiple failed surgeries but finally achieved a natural, balanced nose through autologous rib cartilage reconstruction.

Patient History and Initial Assessment Before Autologous Rib Cartilage Reconstruction

Surgical Timeline:

• Multiple facial surgeries over 12 years, including jaw surgery and rhinoplasties

• Age 23: Nasal implants removed due to facial flushing

• Further surgeries for a deviated nose

• August 2020: Silicone and rib cartilage rhinoplasty at another clinic, plus alar base reduction and three rib harvests

• 2025: Received nasal filler but remained dissatisfied

Preoperative design consultation photos: Frontal view, left oblique side view, and left side view.

Initial Presentation:

• Short nose with upturned tip (front view)

• Acute nasolabial angle and drooping tip (side view)

• Columella deviated left, nostril asymmetry worsened by prior alar reduction

• Septal cartilage severely damaged; alar cartilages missing → poor tip support

Preoperative design consultation photos: Right side view, right oblique side view, and nostril view.

Patient’s Goals:

• Correct crooked nose

• Lower and naturalize tip projection

• Reduce nostril show

• Achieve harmony without artificial sharpness or overcorrection

Surgical Strategy – Autologous Rib Cartilage Reconstruction for Severe Structural Loss

1. Septal Reconstruction & Extension

• Rebuilt septum with rib cartilage

• Extended support to lower tip and restore natural projection

2. Columella & Nostrils

• Straightened deviated columella

• Balanced nasolabial angle for softer contour

3. Alar Cartilage Reconstruction

• Created new alar cartilages from rib

• Restored tip support and symmetry

• Corrected collapsed alar structures

Outcomes and Lessons from Autologous Rib Cartilage Reconstruction

Before Surgery (Left) / Immediately After Surgery (Right)

Aesthetic Results:

• Deviated nose corrected

• Upturned tip lowered with balance

• Nostrils more symmetrical

• Nose complements facial proportions naturally

Before Surgery (Left) / Immediately After Surgery (Right)

Structural Limitations:

• Prior surgeries made perfect nostril symmetry difficult

• Significant improvement achieved with stable, natural results

Before Surgery (Left) / Immediately After Surgery (Right)

Natural Appearance:

• Soft, elegant nasal contour without artificiality

• Patient satisfied, relieved from revision cycle

Surgeon’s Insight

This case of autologous rib cartilage reconstruction emphasizes that when septal and alar cartilages are severely compromised, the goal must shift to natural harmony rather than overcorrection.

Preoperative Video / Immediate Postoperative Video

Key lessons include:

• Careful structural assessment is essential

• Autologous rib cartilage remains the most reliable grafting material

• Patient-centered outcomes prioritize balance and realism

After six surgeries, this patient finally achieved stability, function, and beauty—an inspiring testament to the power of precise, thoughtful reconstruction.

— Dr. Cha-Young Kang, NoseLab Clinic

Postoperative precautions and possible complications after rhinoplasty – includes information on infection, bleeding, asymmetry, allergic reactions, and scarring.

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