Hello, this is Dr. Chayoung Kang, Director of Noselab Rhinoplasty Clinic. Today, I would like to discuss a case involving a patient who had previously undergone rhinoplasty at another clinic.
The patient had initially received cartilage tying surgery that used ear cartilage for the nose tip, without any implant for the bridge of the nose. However, over time, her nose bridge became excessively flat, leading her to get hyaluron fillers. Unfortunately, these fillers made her nose appear unnatural.
After the initial surgery, she began experiencing nasal congestion, which caused significant discomfort. As a result, she visited Noselab to improve both the functionality of her nose and its overall appearance.
Preoperative Design Consultation
Frontal view
Noticeably visible and asymmetric nostrils
Wide, blunt, and deviated nose bridge due to the filler
Side profile
High starting point of the glabella
Overly visible nostrils from the side
Uneven nasal dorsum
45-degree view angle
Obvious filler injections in the nose bridge
Unnatural contour of the nose overall
Nostrils photo
Columella tilted to the left
Noticeable nostril asymmetry
Inner cartilage pressing against the inside of the right nostril
Surgical Contents
Preoperative Nasal Endoscopy Photography
a) Foreign Substance Removal
Complete removal of the filler in the nose bridge, as well as the alloderm and nylon thread in the nose tip.
b) Autologous Rib Cartilage Harvesting and Transplant
Harvested autologous rib cartilage was used to reconstruct the insufficient areas on both sides of the nose. This naturally elevated the nose bridge and strengthened the structure of the nose tip.
c) Septal Correction and Extension Graft
Strengthened the deviated septal cartilage on the right side. Through a septal graft extension, the supporting structure of the nose tip was elevated, improving both its shape and stability.
d) Raising the Nose Bridge
By using autologous rib cartilage alone (non-prosthetic rhinoplasty), we raised the nose bridge in a natural-looking manner.
e) Tied Cartilage Restoring Surgery
The existing nylon thread was removed, and the cartilage was relocated and tied using a different method to improve the condition of the nose tip.
Preoperative nasal endoscopy photography
f) Inferior Turbinate Reduction
To alleviate nasal congestion, we performed a turbinate submucosal resection using a high-frequency laser. Every procedure was conducted using a closed rhinoplasty approach, leaving no external scars.
Before and After Surgery Photos
Previously visible nostrils were covered.
Significant improvement in nostril asymmetry.
Straightening of the previously deviated and blunt nose bridge.
Adjusted the starting point of the glabella.
Smoothed the previously bumpy nose bridge.
Enhanced the appearance of the nose tip.
Improved the unnatural contour caused by the filler.
Achieved a smoother nose line overall.
Straightened the tilted columella.
Greatly improved nostril asymmetry.
Corrected the cartilage that was pressing into the right nostril.
After Surgery Table Photos
Overview
This case exemplifies how complex problems resulting from cartilage tying rhinoplasty and filler injection can be effectively resolved. Notably, the cartilage tying restoration surgery not only secured the structural stability of the nose tip but also achieved a natural shape.
Removing the foreign substances and reconstructing the nose using autologous rib cartilage proved to be the best approach for long-term stability. The use of autologous tissue minimized the risk of rejection and provided ample cartilage, allowing for successful complex reconstructive surgery.
Improving nasal obstruction through septal correction and inferior turbinate reduction is crucial not only for aesthetics but also for functionality. This is where my expertise as an otolaryngologist truly shines. Natural results can be achieved through non-prosthetic surgery, and the overall balance of the nose can be enhanced by lowering the starting point.
I hope this case offers hope to those who are concerned about unsatisfactory results after cartilage tying rhinoplasty. For complex revision surgeries, it is essential to choose a surgeon with extensive experience.
As an ENT specialist, Noselab offers an optimized surgical plan tailored to each patient, based on anatomical knowledge and extensive surgical experience. We aim to create a beautiful and healthy nose through a comprehensive approach that considers both cosmetic and functional improvements.
With Noselab Rhinoplasty Clinic, you can achieve a beautiful and healthy nose.
Thank you.
Noselab Rhinoplasty ClinicDr. Chayoung Kang
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