Closed Rhinoplasty Korea for Septal Extension and Natural Nasal Line Reconstruction

Septal extension with implant replacement is a revision rhinoplasty technique designed to restore nasal tip stability and correct unnatural contours caused by inadequate structural support.

In this case, an overseas patient underwent implant replacement and septal framework reinforcement using autologous rib cartilage, resulting in a stable nasal foundation, improved tip projection, and a natural dorsal line without external scarring.

Author: Dr. Cha-Young Kang, Director, NoseLab Clinic

Published: 2026-01-23

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

This case study presents a revision rhinoplasty patient who developed nasal instability and an artificial appearance after a previous implant-based procedure, requiring structural reconstruction rather than surface-level correction.

Preoperative design consultation photos: Frontal view, left oblique side view, and left side view.

Surgical Background – Implant-Related Instability After Prior Rhinoplasty

The patient presented with insufficient nasal tip support and an unnatural dorsal contour caused by long-term implant dependency.

Eight years after primary rhinoplasty using a silicone implant combined with ear cartilage, the nasal tip gradually lost support and definition. The patient sought correction of instability and a more natural nasal line while avoiding external incisions.

Surgical history:

• Primary rhinoplasty 8 years prior

• Silicone implant with ear cartilage graft

Preoperative design consultation photos: Right side view, right oblique side view, and nostril view.

Surgical Plan – Closed Rhinoplasty Korea for Septal Extension and Implant Replacement

The surgical plan addressed the root cause of instability by rebuilding the internal support framework rather than simply exchanging the implant.

The procedure involved safe removal of the existing silicone implant, custom carving and placement of a new implant, septal extension using autologous rib cartilage, and controlled tip refinement to achieve balanced projection. Rib cartilage reconstruction was selected for its strength, durability, and suitability in revision cases where long-term stability is essential.

Surgical Results – Stable Tip Support and Natural Dorsal Line

Postoperative evaluation confirmed both structural reliability and aesthetic refinement.

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

From the frontal view, nasal symmetry improved and the bridge appeared smoother.

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

From the side profile, a continuous and natural bridge-to-tip curve was achieved with a corrected nasolabial angle.

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

From the nostril view, reinforced tip support created a balanced and stable nasal base.

Overall, the nasal line now appears natural and structurally dependable, reflecting the effectiveness of a structure-first revision strategy using closed rhinoplasty korea in complex implant-related cases.

Surgeon’s Commentary – Why Septal Extension Is Critical in Revision Cases

In revision rhinoplasty, implant replacement alone often results in recurrent tip drooping or progressive instability.

By performing septal extension using autologous rib cartilage, the nasal foundation was re-established, allowing the implant to function as a contouring element rather than a load-bearing structure. This structure-first strategy is especially effective for patients seeking durable and predictable outcomes in revision surgery.

This procedure was performed by Dr. Cha-Young Kang, Chief Director of NoseLab Clinic, following a structure-first, patient-centered philosophy.

FAQ

Q1. Why does nasal tip instability occur after implant rhinoplasty?

Instability occurs when the implant bears structural load without adequate septal support, leading to gradual tip drooping.

Q2. Is septal extension necessary in all revision cases?

Not in all cases, but it is essential when tip support is insufficient or has deteriorated over time.

Q3. Why is rib cartilage preferred for septal reconstruction?

Rib cartilage provides superior strength and long-term stability compared to septal or ear cartilage, particularly in revision surgery.

🎥 YouTube Reference

If you’re curious about Dr. Cha-Young Kang’s closed rhinoplasty approach, click to watch the video.

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