Autologous Rib Cartilage Revision Rhinoplasty for a Deviated Nose and Collapsed Septum

noselab
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Surgical Background – Autologous Rib Cartilage Revision Rhinoplasty

Preoperative views before autologous rib cartilage revision rhinoplasty showing frontal and side profiles — Preoperative design consultation photos: Frontal view, left oblique side view, and left side view.

This case involves a patient who visited our clinic with both aesthetic deformity and functional impairment following multiple prior nasal surgeries. The main concerns included a deviated nasal bridge, an elongated and drooping nasal tip, and a completely collapsed septum. Because the original septal support had been severely damaged, autologous rib cartilage revision rhinoplasty was required to rebuild the nasal framework and restore airway stability.

Surgical history:

First rhinoplasty: 21 years ago
Second rhinoplasty: 4 years ago

The patient sought revision surgery due to dissatisfaction with appearance and persistent breathing difficulties.

Preoperative views before autologous rib cartilage revision rhinoplasty showing side and nostril views — Preoperative design consultation photos: Right side view, right oblique side view, and nostril view.

Surgical Plan – Septal Reconstruction with Rib Cartilage

The surgical plan focused on complete structural reconstruction using rib cartilage to achieve long-term stability and functional recovery.

Key procedures included:

Full septal reconstruction with rib cartilage to reposition the septum to the midline
Reinforcement of nasal tip support to correct drooping
Right alar rebuilding using cartilage grafts to correct asymmetry
Repair of mucosal defects with perichondrial grafting
Removal and recarving of the previous silicone implant to match the nasal bone contour
Correction of the nasolabial angle for a refined side profile

Each step was carefully planned to restore both form and function.

Surgical Results – Functional and Aesthetic Improvement

Postoperative evaluation showed clear improvements in nasal symmetry, proportion, and airflow.

Frontal view: straightened nasal bridge, balanced nostrils, corrected columella deviation
Side view: lifted nasal tip, shorter and more harmonious nasal length, refined dorsal line
Nostril view: improved symmetry and natural tip position
Endoscopic view: septum repositioned to midline, widened right nasal airway, restored mucosa

The reconstructed nasal framework demonstrated excellent stability.

Before and immediately after autologous rib cartilage revision rhinoplasty showing frontal view comparison — Before Surgery (Left) / Immediately After Surgery (Right)

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

Oblique view before and immediately after autologous rib cartilage revision rhinoplasty — Before Surgery (Left) / Immediately After Surgery (Right)

Nostril view before and immediately after autologous rib cartilage revision rhinoplasty — Before Surgery (Left) / Immediately After Surgery (Right)

Surgeon’s Commentary – Why Rib Cartilage Was Necessary

This procedure was not a simple cosmetic revision, but a reconstructive surgery addressing a completely collapsed septum. When septal support is lost, breathing difficulty, chronic rhinitis, and sleep-related issues often follow. In this case, the right nasal airway was nearly obstructed, making rib cartilage reconstruction essential.

Successful autologous rib cartilage revision rhinoplasty must prioritize durable structural support, airway restoration, and natural aesthetics. True success lies in achieving both long-term stability and comfortable breathing.

This surgery was performed by Cha-Young Kang, Chief Director of NoseLab Clinic, using a personalized, patient-centered approach.