Closed Rhinoplasty Korea for Severe Nasal Obstruction Reconstruction

Severe nasal obstruction after multiple rhinoplasty procedures often results from structural collapse of the septum, narrowing of the internal nasal valve, and loss of cartilage support.

In this revision case, comprehensive reconstruction using autologous rib cartilage restored airway stability, corrected structural deformities, and improved both breathing and nasal balance.

This case involves a patient who experienced severe nasal obstruction after undergoing multiple rhinoplasty surgeries at other clinics.

Despite three previous procedures, the patient continued to suffer from worsening breathing difficulty. The primary goal of this revision surgery was therefore functional restoration—rebuilding the internal nasal framework to restore stable airflow.

Surgical Background – Closed Rhinoplasty Korea

Revision rhinoplasty often requires complex reconstruction of damaged internal nasal structures.

For this reason, closed rhinoplasty korea was selected to allow precise internal structural reconstruction without external incisions, while minimizing additional soft-tissue trauma in a revision setting.

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

Structural Problems Identified

Detailed examination revealed several structural abnormalities responsible for the patient’s severe nasal obstruction:

• Collapse of the septum toward the right side

• Narrowing of the internal nasal valve

• Excessive lateral osteotomy from previous surgery

• Depressed mid-dorsum caused by over-resection of nasal bone

• Damage to the alar cartilages and thinning of nasal tip skin

• Adhesions and abnormal positioning of the inferior turbinate

Because these problems were interrelated, a comprehensive structural reconstruction plan was necessary.

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

Surgical Plan – Comprehensive Structural Reconstruction

Septal Reconstruction

Septal collapse had significantly narrowed the internal nasal airway.

Procedures included:

• Septal reconstruction using autologous rib cartilage

• Restoration of stable midline septal support

• Re-expansion of the internal nasal valve airway

This step restored the fundamental structural support of the nose.

Osteotomy Restoration

Previous cosmetic surgery had excessively narrowed the nasal cavity.

Key findings included narrowing of the internal nasal space and a depressed mid-dorsum due to over-resection of bone.

Procedures performed:

• Osteotomy restoration to reopen the nasal cavity

• Rib cartilage grafting to correct the depressed mid-dorsum

• Slight structural overcorrection to account for natural postoperative settling

Nasal Tip Skin Reinforcement and Alar Cartilage Reconstruction

Repeated surgeries had severely weakened the nasal tip tissues.

Procedures performed:

• Reinforcement of nasal tip skin using dermis and rib perichondrium

• Reconstruction of damaged alar cartilages using rib cartilage

• Restoration of stable nasal tip support

Inferior Turbinate Repositioning

Previous rhinitis surgery had excessively reduced the inferior turbinates, creating structural imbalance and airway problems.

Additional findings included turbinate displacement and adhesion to the lateral nasal wall.

Procedures performed:

• Medial repositioning of the inferior turbinate

• Release of adhesions to restore airway space

• Preventive measures to reduce the risk of re-adhesion

Nasolabial Angle Adjustment

The nasolabial angle was refined to improve facial profile harmony.

Adjustment of the relationship between the nose and upper lip created a more balanced side profile.

Surgical Results

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

Functional Improvement

Breathing function improved significantly after reconstruction.

• Septal reconstruction restored stable internal support

• Internal nasal valve reconstruction reopened the airway

• Osteotomy restoration expanded the nasal cavity

• Inferior turbinate repositioning improved right-sided airflow

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

Aesthetic Improvement

Structural reconstruction also improved nasal appearance.

• Depressed mid-dorsum corrected

• Nasal tip stability restored

• Balanced nasal profile achieved

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

Structural Stability

Strong internal support was achieved through rib cartilage reconstruction of the septum and alar cartilages.

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

Surgeon’s Commentary

Severe nasal obstruction after multiple rhinoplasty procedures usually results from combined structural damage rather than a single anatomical problem.

In this patient, airway compromise was caused by septal collapse, excessive osteotomy narrowing the nasal cavity, turbinate abnormalities, and loss of cartilage support.

Addressing only one of these issues would not have resolved the patient’s breathing difficulty.

Through septal reconstruction, osteotomy restoration, alar cartilage reconstruction, turbinate repositioning, and internal nasal valve expansion, the nasal airway and structural stability were successfully restored.

Autologous rib cartilage was selected because it provides the most reliable structural support in complex revision cases where native cartilage has been severely compromised.

Revision rhinoplasty involving functional airway problems requires meticulous planning and advanced reconstructive techniques to achieve durable outcomes.

(FAQ)

Q1. Why does nasal obstruction occur after rhinoplasty?

It can result from septal collapse, narrowing of the nasal valve, excessive osteotomy, or loss of cartilage support after previous surgery.

Q2. Why is rib cartilage used in complex revision rhinoplasty?

Rib cartilage provides strong and durable structural support when existing nasal cartilage is insufficient.

Q3. Can breathing problems be corrected during revision rhinoplasty?

Yes. Septal reconstruction, nasal valve correction, and turbinate surgery can significantly improve nasal airflow.

🎥 YouTube Reference

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

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