Closed Nasal Inflammation Revision Surgery with Rib Cartilage Graft

Dr. Chayoung Kang
2025년 1월 29일
2분 분량

최종 수정일: 2025년 9월 26일

Overview of Closed Nasal Inflammation Revision Surgery

This patient presented with severe chronic inflammation and structural damage due to previously inserted foreign materials in the nose, including silicone and Medpor. The inflammation had spread deeply, causing necrosis of the septal cartilage, asymmetry of the nostrils, and exposure through the mucosa.

Preoperative design consultation for closed nasal inflammation revision surgery – frontal, oblique, and side views before rib cartilage graft. — Preoperative design consultation photos: Frontal view, left oblique side view, and left side view.

Preoperative consultation for closed nasal inflammation revision – right side, oblique, and nostril views before rib cartilage reconstruction. — Preoperative design consultation photos: Right side view, right oblique side view, and nostril view.

Previous Surgical History Before Closed Revision Surgery

Early rhinoplasty with septal deviation correction
Multiple revisions with Alloderm and silicone
Recent findings: Medpor exposure through mucosa with inflammation

Preoperative Findings Related to Nasal Inflammation

Nasal endoscopy revealed exposed Medpor in the left nasal cavity
CT scan showed severe septal deviation and turbinate hypertrophy
Visually confirmed asymmetry and swelling of the nasal tip

Nasal endoscopy showing Medpor extrusion through inflamed mucosa – key finding before closed nasal inflammation revision surgery. — These are nasal endoscopy photos.

Closed Revision Surgery Plan and Procedure

Removed foreign materials during closed nasal inflammation revision: fragmented Medpor, extruded Medpor from left mucosa, and silicone implant from nasal bridge. — Photos of Removed Foreign Materials: 1.Medpor , 2.Medpor that Penetrated Through the Left Mucosa , 3.Silicone Implant from the Nasal Bridge

Closed Approach: Avoiding further scarring or skin damage
Removal of All Foreign Materials: Silicone, Alloderm, and Medpor fragments
Debridement of inflamed tissues
Septal and Tip Reconstruction using minimally calcified rib cartilage
Alar Base Support to restore symmetry and stability
Dorsal Line Refinement to correct bulbous tip and deviation

Rib Cartilage-Based Reconstruction in Inflammation Revision

Rib cartilage was shaped using 3D template guidance
Cartilage was layered to form a natural dorsal line
Asymmetry and upturned nostril were corrected

Results of Closed Nasal Inflammation Revision Surgery

Frontal comparison of nasal inflammation revision case: Before surgery (left) showing implant protrusion and skin redness, and immediately after closed nasal inflammation revision surgery (right). — Before Surgery (Left) / Immediately After Surgery (Right)

Side view comparison of closed nasal inflammation revision: Before surgery (left) shows nasal tip bulbosity and implant shadow, and immediately after surgery (right) shows refined dorsal line and resolved inflammation. — Before Surgery (Left) / Immediately After Surgery (Right)

Three-quarter view comparison of closed nasal inflammation revision: Before surgery (left) shows implant-related shadowing and nasal swelling; immediately after surgery (right) shows improved tip projection, reduced inflammation, and natural skin contour. — Before Surgery (Left) / Immediately After Surgery (Right)

Base view comparison of nostrils before and after closed nasal inflammation revision: Preoperative view (left) shows symmetrical nostrils with implant bulging; postoperative view (right) reveals removed implant area with inflammation and exposed tissue inside the nostrils. — Before Surgery (Left) / Immediately After Surgery (Right)

Balanced nasal tip and straight dorsal line
Improved nostril symmetry and projection
Clear nasal airway with improved breathing function
No external scars due to closed approach
All inflammation-related structures removed completely

Expert Commentary on Closed Nasal Inflammation Revisions

Immediately after closed nasal inflammation revision: Frontal, side, and oblique views showing post-surgical swelling, redness along the nasal bridge, and improved nostril symmetry following implant removal. — Immediately after surgery: Frontal view, side view, and oblique side view photos.

Immediately after closed nasal inflammation revision: Nostril view showing raw tissue and inflammation at the inner nostrils after implant removal. — Immediately after surgery: Nostril view photos.

This case illustrates the importance of addressing nasal inflammation early and choosing biocompatible materials. Closed nasal inflammation revision surgery is technically demanding but allows for full restoration while preserving the skin envelope. In patients with prior Medpor or synthetic graft complications, autologous reconstruction offers the safest long-term outcome.

Dr. Cha-Young Kang

Director, Nose Lab Clinic

Thank you.