Columella Retraction Correction in Contracted Nose Reconstruction: A Case Study

noselab
2024년 10월 27일
2분 분량

최종 수정일: 9월 29일

Understanding Columella Retraction Correction and Contracted Nose Reconstruction

Columella retraction correction is a critical step in restoring nasal aesthetics and function, especially in patients with severe contracted noses. When the septum is damaged from previous surgeries or infections, it often leads to columella retraction, nasal shortening, and obstruction.

Patient Case Overview: Columella Retraction Correction After Contracted Nose

This patient previously underwent full removal of inflamed nasal tissue, leading to a contracted nose and significant columella retraction. Before surgery, we completed four sessions of stem cell therapy over two weeks to reduce inflammation and prepare the tissue for reconstruction.

Preoperative design consultation photos showing frontal view, left oblique side view, and left side view before columella retraction correction and contracted nose reconstruction. — Preoperative design consultation photos: Frontal view, left oblique side view, and left side view.

Preoperative Analysis and Observations

On side view, the columella was not visible.
The profile appeared flat, lacking projection and support.
Frontal view showed a wide nasal bridge, slightly crooked nose, and drooping alar base due to columella retraction.
Nostril asymmetry from prior surgeries was also observed.

Preoperative design consultation photos showing right side view, right oblique side view, and nostril view before columella retraction correction and contracted nose reconstruction. — Preoperative design consultation photos: Right side view, right oblique side view, and nostril view.

Surgical Plan for Contracted Nose Reconstruction

To achieve durable columella retraction correction, our approach included:

Removal of all residual filler and silicone
Harvesting new autologous rib cartilage
Reuse of septal and ear cartilage if viable
Septal extension graft using rib cartilage
Alar cartilage and nostril rim reconstruction
Skin and dermal grafting (from retroauricular area) for columellar support

Intraoperative Findings and Rib Cartilage Application

CT scan with surgical planning for columella retraction correction and contracted nose reconstruction, showing rib cartilage graft design and septal reconstruction areas. — Only 30% of the native septum remained. The contracted nose required full reconstruction of the septum using rib cartilage, including correction of deviation and removal of septal spurs. We also rebuilt the nasal tip and nostril rims using rib cartilage and skin grafts for structural and aesthetic balance.

Postoperative Outcome: Successful Columella Retraction Correction

Before and after side view of contracted nose reconstruction with columella retraction correction, highlighting natural nasal tip projection and restored nasolabial angle. — Before Surgery (Left) / Immediately After Surgery (Right)

Before and after frontal view of columella retraction correction and contracted nose reconstruction, showing improved nasal bridge alignment and balanced tip projection. — Before Surgery (Left) / Immediately After Surgery (Right)

Before and after nostril view of contracted nose reconstruction with columella retraction correction, showing restored nostril symmetry and columellar support. — Before Surgery (Left) / Immediately After Surgery (Right)

The nasolabial angle was restored to ~95 degrees.
Nasal tip projection was enhanced naturally.
The retracted nostrils regained symmetry.
Bridge width and alar base position improved.
No signs of postoperative inflammation or implant complications.

Why Septal Reconstruction Is Essential for Contracted Nose Correction

Columella retraction correction is not long-lasting if the underlying septum remains damaged. By reconstructing the nasal septum with rib cartilage, we provided foundational support that prevents recurrence. This complex procedure is best performed by specialists in closed rhinoplasty and structural reconstruction.

Conclusion: Long-Term Improvement with Rib Cartilage-Based Contracted Nose Reconstruction

This case demonstrates how combining stem cell therapy, rib cartilage grafts, and precise structural planning leads to a durable, aesthetic, and functional correction of columella retraction and contracted nose.

Thank you,

Dr. Cha-Young Kang, Director of Nose Lab Clinic.