Complex Revision Rhinoplasty – Rebuilding Hope After 7 Surgeries in 20 Years

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Complex Revision Rhinoplasty – Rebuilding Hope After 7 Surgeries in 20 Years

Hello, I’m Dr. Cha-Young Kang, Director of NoseLab Clinic.

Today, I’d like to share one of the most meaningful cases in my career—an extraordinary journey of a patient who underwent seven rhinoplasty revisions over 20 years, finally achieving structural stability, functional recovery, and a renewed appearance through complex revision rhinoplasty.

Complex Revision Rhinoplasty – Patient History and Challenges

Preoperative design consultation photos for complex revision rhinoplasty – frontal, left oblique side, and left side views of female patient — Preoperative design consultation photos: Frontal view, left oblique side view, and left side view.

Surgical Timeline:

20 yrs ago: Dermal filler injection
16 yrs ago: 1st surgery – rib cartilage + silicone + ear cartilage (nose appeared overly long)
14 yrs ago: 2nd revision – donor rib + silicone + ear cartilage + Alloderm (over-projection)
11 yrs ago: 3rd revision – silicone + donor rib (foreign material left behind)
8 yrs ago: 4th revision – donor rib + silicone + ear cartilage + Alloderm (swelling, translucency)
5 yrs ago: 5th revision – crushed rib + temporalis fascia (contracture, over-projection)
2 yrs ago: 6th revision – autologous rib (silicone translucency persisted)
8 mos ago: 7th revision – rib cartilage with crush graft technique

reoperative design consultation photos for complex revision rhinoplasty – right oblique side, right side, and nostril views of female patient — Preoperative design consultation photos: Right side view, right oblique side view, and nostril view.

Presenting Problems:

Structural collapse: Severe septal loss, keystone area destroyed, unstable framework
Functional compromise: Severe left-sided obstruction, pain, valve stenosis
Aesthetic deformities: Saddlenose, irregular dorsum, bulging alae, nostril asymmetry

Surgical Plan for Complex Revision Rhinoplasty – Total Structural Reconstruction

Structural Restoration:

Rebuilt nasal framework with autologous rib cartilage (septum, alar, keystone)
Corrected septal deviations, reconstructed internal nasal valve
Stabilized collapsed dorsum and tip

Aesthetic Refinements:

Smoothed depressed, irregular dorsal line
Reshaped bulging alae
Corrected nostril asymmetry

Technical Focus:

Keystone and septal reconstruction prioritized to restore stability
Extended surgical time and recovery management carefully monitored

Postoperative Care:

Recovery expected 2–3 times longer than primary surgery
Strict protection against trauma until full stabilization
Regular follow-up for structure and breathing assessment

Outcomes and Recovery in Complex Revision Rhinoplasty

Before and immediately after complex revision rhinoplasty – frontal comparison of female patient — Before Surgery (Left) / Immediately After Surgery (Right)

Functional Results:

Restored airflow through valve reconstruction
Significant relief from nasal pain and obstruction
Stable nasal framework without shakiness

Before and after complex revision rhinoplasty – side view comparison of female patient — Before Surgery (Left) / Immediately After Surgery (Right)

Aesthetic Results:

Saddlenose deformity corrected
Smooth, natural dorsal contour achieved
Symmetry restored in nostrils and nasal base
Harmonized overall facial proportions

Before and after complex revision rhinoplasty – oblique side view comparison of female patient — Before Surgery (Left) / Immediately After Surgery (Right)

⚠️ Key Lesson

Even after repeated surgeries and severe collapse, structural rebuilding with rib cartilage can restore both function and aesthetics—when performed with precision planning and patience.

Before and after complex revision rhinoplasty – nostril/base view comparison of female patient — Before Surgery (Left) / Immediately After Surgery (Right)

Surgeon’s Medical Insight

Immediately after complex revision rhinoplasty – frontal, side, and oblique side views of female patient — Immediately after surgery: Frontal view, side view, and oblique side view photos.

Immediately after complex revision rhinoplasty – nostril/base view of female patient — Immediately after surgery: Nostril view photos.

Medical literature supports that:

Severe deformities usually stem from septal and keystone collapse; rib cartilage reconstruction is the gold standard 【NCBI / JAMA】
Rebuilding the keystone-septal framework restores long-term stability 【NCBI】
Revision rhinoplasty improves nasal function in over 85% of cases when valve correction is included 【NY Facial Plastic Surgery】

This case reminds us that resilience, accurate diagnosis, and expert planning make even the most complex revisions possible.

— Dr. Cha-Young Kang, NoseLab Clinic