Correcting Cartilage Show-Through and Over-Projected Nasal Tip – Autologous Dermis Revision Rhinoplasty Case

noselab
2월 24일
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최종 수정일: 9월 26일

[Nose Lab Clinic]

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

Today, I’m introducing a case of revision rhinoplasty using autologous dermis grafting to address a sharp nasal tip and visible cartilage show-through. The patient had undergone multiple previous surgeries, which caused thinned nasal skin, structural weakness, and unnatural nasal contour — requiring a tailored, advanced approach.

Preoperative consultation photos (frontal, side, and oblique views) showing nasal tip cartilage show-through and structural issues before revision rhinoplasty. — Design Consultation: Frontal View, Left Side View, and Oblique Side View Photos

Patient History and Examination – Why Cartilage Show-Through Occurs

a. Past Surgical History

7–8 years ago: Filler injection (later dissolved)
3 years ago: Septal cartilage + ear cartilage graft
March 2024: Silicone implant + rib cartilage
August 2024: Alloderm + tip refinement

b. Preoperative Observations

Structural Issues

Thin nasal tip skin
Cartilage show-through at the tip
Overly sharp, pointed nasal tip
Elongated nasal appearance

Aesthetic Concerns

Mild nasal deviation
Narrow nasal bridge and tip
Excessive nostril exposure
Thin columella

Functional Issues

Chronic nasal congestion
Allergic rhinitis symptoms

Preoperative consultation images (right side, oblique, and nostril views) highlighting cartilage show-through, nasal tip sharpness, and excessive nostril exposure before revision surgery. — Design Consultation: Right Side View, Oblique Side View, and Nostril View Photos

Patient’s Goals – Eliminate Cartilage Show-Through and Restore Balance

🔹 Soften the overly sharp nasal tip

🔹 Reduce excessive nostril show

🔹 Reposition the columella for nasolabial harmony

🔹 Eliminate cartilage visibility for a natural contour

Surgical Plan and Execution Using Autologous Dermis Grafting

a. Structural Reinforcement

Lateral osteotomy to realign the nasal bone
Harvested autologous dermis from the postauricular region
Dermis graft placement at the nasal tip to mask cartilage show-through and thicken the skin

b. Aesthetic Refinement

Elevate columella to improve nasolabial angle
Soften nasal tip projection
Slight widening of the nasal tip and bridge for better proportion

c. Functional Improvement

Treat allergic rhinitis
Correct internal airway blockage
Secure long-term nasal structure and airflow

Postoperative Results – Clear Resolution of Cartilage Show-Through

Frontal View

Softer, natural nasal tip contour
Proper skin thickness masking cartilage
Symmetrical nasal shape

Side View

Improved nasolabial angle
Stabilized tip structure
Balanced facial profile

Oblique view comparison: Before (left) and immediately after (right) revision rhinoplasty to correct sharp nasal tip and cartilage show-through. — Before (Left) / Immediately After (Right)

Functional Outcomes

Enhanced breathing
Less nasal congestion
Stable long-term structural results

Nostril base view comparison: Before (left) and immediately after (right) revision rhinoplasty to correct cartilage show-through at the nasal tip. — Before (Left) / Immediately After (Right)

Expert Insight – Why Cartilage Show-Through Needs a Precise Strategy

Key Challenges:

Multiple surgeries resulted in extremely thin skin, requiring structural support to avoid translucency.
Directly shaving cartilage could compromise stability — hence, autologous dermis grafting was used instead.
Revision required balance between form and function.

Key Takeaways:

Cartilage show-through must be corrected with tissue grafting, not just trimming.
Dermis grafting provides soft tissue coverage for visible cartilage.
Meticulous revision can restore both function and aesthetics.