Closed Rhinoplasty Korea for Complete Nasal Reconstruction

noselab
16시간 전
3분 분량

Complete nasal reconstruction is a revision rhinoplasty procedure that restores severely damaged septal and alar structures using structural grafting rather than cosmetic reshaping alone.

In this case, near-total loss of native cartilage was addressed through full septal and alar reconstruction with autologous rib cartilage, achieving long-term structural stability and improved nasal balance without external incisions.

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

This case involves a patient who developed severe nasal deformity and internal structural loss after multiple previous rhinoplasty procedures.

Patient Condition and Key Problems

The patient presented with nasal deviation, nostril asymmetry, reduced dorsal height, and instability caused by extensive destruction of internal support structures.

Preoperative CT imaging revealed abnormal findings around an existing implant, raising concern for chronic foreign body reaction and capsule formation.

Preoperative design consultation images showing frontal view, left oblique side view, and left lateral view of a patient with nasal deviation and structural deformity following multiple prior rhinoplasty procedures. — Preoperative design consultation photos: Frontal view, left oblique side view, and left side view.

Surgical Background – Complete Septal Reconstruction with Closed Rhinoplasty Korea

Severe structural damage after repeated rhinoplasty requires full internal reconstruction rather than isolated implant replacement.

For this reason, closed rhinoplasty korea was selected to allow complete access for septal and alar reconstruction while minimizing additional soft tissue trauma.

Preoperative design consultation images showing right lateral view, right oblique side view, and nostril view of a patient with nasal deviation and structural deformity following multiple prior rhinoplasty procedures. — Preoperative design consultation photos: Right side view, right oblique side view, and nostril view.

Surgical history

Four rhinoplasty procedures over approximately 10 years
Previous use of silicone, ear cartilage, donated rib cartilage, and autologous rib cartilage

Surgical Plan – Structural & Functional Reconstruction

The surgical plan focused on rebuilding the nasal framework and preventing future instability.

Key procedures included:

Complete removal of all implants and fibrotic capsules
Intraoperative identification of serous fluid and exclusion of active infection
Full septal reconstruction using autologous rib cartilage
Bilateral alar cartilage reconstruction using autologous rib cartilage
Conservative dorsal height restoration within biologically safe limits
Correction of nostril asymmetry using internal skin grafting

Long-term stability was prioritized over aggressive cosmetic augmentation.

Surgical Results – Restored Structure and Stable Nasal Framework

Postoperative evaluation confirmed successful structural restoration.

Frontal view comparison showing preoperative nasal appearance on the left and immediate postoperative condition on the right after structural nasal reconstruction. — Before Surgery (Left) / Immediately After Surgery (Right)

Frontal view: Nasal deviation corrected to a straight alignment with improved symmetry.

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

Side profile:Dorsal height safely restored with a smooth bridge contour and soft nasal tip.

Left oblique view comparison showing preoperative nasal contour on the left and immediate postoperative appearance on the right after structural nasal reconstruction. — Before Surgery (Left) / Immediately After Surgery (Right)

Nostril view:Improved symmetry and stable columella position.

Nostril view comparison showing preoperative nasal airway narrowing on the left and immediate postoperative appearance on the right after structural nasal reconstruction. — Before Surgery (Left) / Immediately After Surgery (Right)

The primary outcome was reconstruction of a stable internal framework rather than maximal height enhancement.

Surgeon’s Commentary – Why Autologous Rib Cartilage Was Essential

In patients with multiple prior rhinoplasty procedures, native septal and alar cartilages are often severely damaged or absent.

In this case, autologous rib cartilage was required to rebuild the entire internal framework and provide long-term stability. Because CT imaging showed abnormal findings around the implant, determining the presence of infection was critical. The presence of serous fluid without pus allowed safe capsule removal, antibiotic irrigation, and complete reconstruction.

After implant removal, partial nasal bone erosion and reduced dorsal height were observed. Given the weakened tissue condition, aggressive height augmentation was intentionally avoided. If additional height is desired, secondary adjustment can be considered after full tissue stabilization.

Successful revision rhinoplasty depends on accurate assessment of remaining structures, appropriate graft selection, and a conservative, staged approach.

FAQ – Complete Septal Reconstruction in Revision Rhinoplasty

Q1. Is closed rhinoplasty suitable for complex revision cases?

Yes. Closed rhinoplasty can be used for complex revisions when extensive internal reconstruction is required and performed by surgeons experienced in structural techniques.

Q2. When is autologous rib cartilage necessary in revision rhinoplasty?

Rib cartilage is used when septal and alar cartilages are severely damaged or absent and strong structural support is required.

Q3. Why is a conservative approach important in revision surgery?

Previously operated tissues are often weakened, and conservative reconstruction reduces complication risk and improves long-term stability.