Case Study: Contracted Nose Correction with Residual Foreign Substance Removal

noselab
2024년 11월 28일
3분 분량

최종 수정일: 9월 26일

Hello, this is Dr. Cha-Young Kang, the director of Nose Lab Clinic.

Today, I’m sharing a case of a patient who suffered complications from multiple rhinoplasty surgeries, including inflammation and a contracted nose due to residual foreign materials. This case demonstrates the importance of comprehensive contracted nose correction with meticulous removal of problematic substances.

Patient’s Surgical History

2007: L-shaped silicone implant
2021: Silicone + ear cartilage (resulted in inflammation)
2023 (Nov): Silicone + mesh + “cat nose” surgery (caused upturned nose)
2023 (Nov): Silicone + rib cartilage + dermis + periosteum (led to inflammation, PRP 16 sessions)

Design consultation photos: frontal, left side, and oblique side view before contracted nose correction surgery — Design Consultation: Frontal View, Left Side View, and Oblique Side View Photos

Main Symptoms of Contracted Nose

Structural Issues: Contracted nose due to chronic inflammation
Inflammation: Persistent swelling from residual foreign materials
Nasal Tip Collapse: Implant extended to tip, causing depression
Pain and Tenderness: Especially in upper lip and surrounding area
Left Nasal Obstruction: Caused by mesh remnants and deviated septum

Design consultation photos: right side, oblique side, and nostril view before contracted nose correction surgery — Design Consultation: Right Side View, Oblique Side View, and Nostril View Photos

Surgical Plan for Contracted Nose Correction

Structural Reconstruction with Rib Cartilage

Rib cartilage graft to reconstruct nasal tip and septum
Nostril base lowering and nasolabial angle correction

Removal of Residual Foreign Substances

Complete removal of silicone, mesh, and inflammatory tissue

Functional Improvements

Septoplasty to correct deviation
Submucosal resection with high-frequency laser for turbinate reduction

Skin Grafting and Augmentation

Postauricular skin graft to repair contracted tissue and restore coverage

Intraoperative Findings

Silicone Implant Malposition: Extended to tip, thinning tissue and causing inflammation.

The End of the Silicone Implant Located Just Below the Depressed Skin

Residual Mesh: Found in septal mucosa, removed completely.

Mesh fragments removed during contracted nose correction surgery — Mesh Fragments Removed During Surgery

Displaced Rib Cartilage Grafts: From prior “cat nose” surgery, tilted and misaligned, removed.

The rib cartilage from a previous surgery, shaped for a "cat nose," was inserted tilted toward the right side, causing pain below the right columella. It was determined to be the source of the issue and was removed.

Severe Inflammation: Chronic reactive tissue excised extensively.
Septal Damage: Major absence and deviation, reconstructed with rib cartilage.

Pre-Surgical Analysis

Frontal View: Nostril retraction, pinched alar base, asymmetry, crooked bridge
Side View: High starting point, short and collapsed tip, excessive nasolabial angle
Nasal Base: Asymmetrical nostrils, deviated columella, retracted base

Postoperative Outcomes After Contracted Nose Correction

Frontal View

Reduced nostril retraction
Corrected alar base asymmetry
Straight nasal bridge with improved balance

Side View

Lowered nasal starting point
Stable and natural nasal tip
Balanced nasolabial angle

Nasal Base

Enhanced nostril symmetry
Centered columella
Natural, balanced nostril shape

Specialist Considerations in Contracted Nose Correction

This case underscores the critical importance of thoroughly removing residual foreign substances during contracted nose correction.

Residual Silicone and Mesh: Fully removed to prevent further inflammation.
Structural Reconstruction: Rib cartilage provided long-term support and stability.
Skin Grafting: Postauricular skin restored nasal coverage and prevented recurrence of contraction.

Immediately after contracted nose correction: frontal, side, and oblique view photos — Immediately After Surgery: Frontal, Side, and Oblique Side Views

Immediately after contracted nose correction: nostril view photo — IImmediately After Surgery:Nostril

Recovery and Maintenance

Intensive antibiotics to control inflammation
Stem cell therapy for tissue healing and scar prevention
Continuous monitoring to ensure stable functional and aesthetic outcomes

Closing Remarks

This case highlights how careful planning, complete removal of residual foreign materials, and advanced contracted nose correction techniques can restore both structure and aesthetics in highly complex cases.

At Nose Lab Clinic, we provide tailored solutions that address both functional needs and cosmetic goals for each patient.

Thank you for reading.

This is Dr. Cha-Young Kang from Nose Lab Clinic.