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Chronic Foreign Body Reaction After Orthognathic Surgery – A Case of Septal Reconstruction with Rib Cartilage

  • noselab
  • 4월 8일
  • 2분 분량

최종 수정일: 9월 26일

[Nose Lab Clinic]


Hello, this is Dr. Cha-Young Kang from Nose Lab Clinic.


Today, I’m presenting a complex revision rhinoplasty case involving a chronic foreign body reaction after orthognathic surgery that led to severe septal cartilage damage. Using autologous rib cartilage, we successfully reconstructed the nasal framework and achieved both aesthetic and functional improvement.

Preoperative design consultation for a patient with chronic foreign body reaction after orthognathic surgery. Frontal, side, and oblique views were used to evaluate asymmetry and nasal contour before closed rhinoplasty with rib cartilage reconstruction.
Design Consultation: Frontal View, Left Side View, and Oblique Side View Photos

Patient Background and Surgical History

  • 15 years ago: Orthognathic (jaw) surgery

  • 10 years ago: Nose filler injections (dissolved)

  • 10 years ago: Alar base elevation surgery

  • 2 years ago: Rib cartilage graft + silicone implant rhinoplasty


Initial Assessment of Chronic Foreign Body Reaction After Orthognathic Surgery

Right side, oblique side, and nostril view photos taken during the design consultation for a patient with chronic foreign body reaction and columella deviation following orthognathic surgery. Used to assess nasal projection, symmetry, and nostril contour before closed revision rhinoplasty.
Design Consultation: Right Side View, Oblique Side View, and Nostril View Photos

Frontal View

  • Widened nasal bridge

  • Bulbous tip

  • Excessive nostril exposure

  • Nostril asymmetry

Side Profile

  • High radix

  • Upturned nasal tip

  • Unnatural columella-bridge transition

Oblique View

  • Mild mouth protrusion

  • Bulky nasal contour

Nostril View

  • Asymmetric nostrils

  • Leftward deviation of the columella


Patient’s Concerns and Desired Outcome

  • Correction of the upturned nose

  • Refinement of columella-labial angle

  • Achieving a natural, unsculpted result

  • Harmonizing nostril exposure

The patient provided multiple reference photos from social media to express their aesthetic goals, mainly featuring slim nasal bridges, natural dorsal lines, and a refined columella-labial angle.
The Desired Images of the Patient

Surgical Plan for Chronic Foreign Body Reaction After Orthognathic Surgery

Foreign Body Management

  • Chronic serous fluid from implant site

  • Capsule removal and thorough irrigation

  • Sample culture and antibiotic therapy

Septal Reconstruction

  • Severe septal damage from past jaw surgery

  • Rib cartilage used to reconstruct and support septum

Aesthetic Refinement

  • Lowered radix

  • Natural bridge-to-tip flow

  • Improved nostril balance and visibility


Postoperative Results After Treating Chronic Foreign Body Reaction

Before and immediately after surgery: frontal comparison showing refined nasal bridge and less nostril exposure
Before Surgery (Left) / Immediately After Surgery (Right)

Frontal View:

  • Slimmer nasal bridge

  • Refined tip

  • Less visible nostrils

Before and after side profile images showing corrected upturned tip and improved columella-labial angle
Before Surgery (Left) / Immediately After Surgery (Right)

Side Profile:

  • Balanced radix

  • Smooth profile

  • Corrected upturn

Oblique view before and after surgery showing more natural profile transition and refined nasal contou
Before Surgery (Left) / Immediately After Surgery (Right)

Nostril View:

  • Symmetrical nostrils

  • Straight columella

  • Harmonized base

Nostril view comparison showing reduced asymmetry and corrected columella deviation
Before Surgery (Left) / Immediately After Surgery (Right)

Expert Insights – Managing Chronic Foreign Body Reaction After Orthognathic Surgery

Immediate post-surgery views: frontal, side, and oblique side showing structural balance and natural nasal shape
Immediately after surgery: Frontal view, side view, and oblique side view photos.
Close-up nostril view immediately after surgery showing symmetrical nostrils and stable septal reconstruction
Immediately after surgery: Nostril view photos.













Bulky bridge was due to serous reaction, not tissue alone

  • Severe septal loss needed full rib cartilage reconstruction

  • Functional and aesthetic issues addressed together

All surgeries at Nose Lab Clinic are performed through a closed (endonasal) approach.

Messenger(WhatsApp) : +82 1057360302


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