Contractured Nose Correction with Nasal Congestion Improvement _ Rhinoplasty Korea

noselab
2024년 8월 26일
3분 분량

최종 수정일: 11월 28일

Hello, this is Dr. Chayoung Kang, Director of Noselab Rhinoplasty Clinic.Today, I will introduce a complex case of contractured nose correction with nasal congestion improvement through closed rhinoplasty.

This patient had undergone several rhinoplasty surgeries in the past, which led to nasal contracture, septal cartilage loss, and severe nasal congestion. The patient was particularly concerned about the upturned nose, retracted columella, visible nostrils, and asymmetric nasal bone.

Patient’s Concerns Before Contractured Nose Correction

Preoperative frontal view – contractured nose with asymmetry and visible nostril exposure | Contractured Nose Correction — Frontal view

Excessively visible nostrils
Short nose
Noticeable nose bone asymmetry
Flat nasal bridge (implant had been removed)

Side profile view

Unnatural nose bridge shape and upturned nose tip
Wide nasolabial angle
Unnatural nostril shape from the side profile view (unsatisfactory parts)

Preoperative 45-degree angle photo – contractured nose with drooping tip and nasal bridge depression | Contractured Nose Correction — 45-degree angle

Significantly depressed nasal bridge.
Upturned nasal tip.

reoperative nostril base view – contractured nose showing nostril asymmetry and retracted columella | Contractured Nose Correction — Nostrils photo

Excessively thick columella.
Evident nostril asymmetry
Visible scar tissue on both sides of the columella

Patient’s medical history

10 years ago: surgery using silicone and ear cartilage
8 years ago: surgery using septal cartilage and silicone
5 years ago: silicone and donated rib, nostril reduction surgery.
1 year ago: self-rib cartilage and silicone, philtrum reduction surgery.

Surgical details

The following surgeries were performed through closed rhinoplasty.

a) Removal of the silicone implant (1st surgery – treatment for the contracture)

Safe silicone implant removal.

b) Beginning of the stem cell treatment after the implant removal:

3 sessions of stem cell treatment during 3 months before surgery.

c) Autologous rib cartilage and transplant.

Reconstruction of the nose tip using the rib cartilage, and septal cartilage extension graft and reconstruction.

d) Lateral osteotomy of the nasal bone.

To improve the appearance of the wide nasal bone and the asymmetrical parts.

e) Septoplasty.

Straightening the septum to improve the nasal congestion.
After checking during the surgery, we confirmed that there was barely any septal cartilage left, so we performed septal cartilage reconstruction.

f) Turbinate submucosal resection

To improve the symptoms of nasal congestion, we used a high-frequency laser to reduce the size of the thick inferior turbinates.

g) Nose tip correction

Improvement of the considtion and lowering of the upturned nose tip through the septal extension graft and septal reconstruction.

h) Columella reconstruction.

Improvement of the general balance of the nose through the reconstruction of the retracted columella.

All procedures were performed through closed rhinoplasty, completing the surgery without external scars.

Before and After Surgery Photos

Frontal view before surgery (left) after surgery (right)

Adjustment of the excessively visible nostrils/
The facial proportion improved by correcting the lenght of the short nose.
A more balance appearance after correcting the nasal bone asymmetry.
The previously plain nasal bridge took on a more natural shape.

Side profile view before surgery (left) after surgery (right)

The previously unnatural nose shape and upturned nose tip became smoother and natural.
Improvement of the harmony of the lips and nose tip through the nasolabial angle correction.
Great improvement of the nostril shape to be more natural.

45-degree angle view before surgery (left) after surgery (right)

Adjustment of the depressed nose bridge to become more three-dimensional.
Enhancement of the overall balance of the nose by lowering the previously upturned nose tip.

Nostril view before surgery (left) and after surgery (right) – correction of contractured nose with improved columella alignment and nostril symmetry | Contractured Nose Correction

Improvement of the thickness of the columella.
Great improvement of the nostril asymmetry.
Reduction of the scar tissue on both sides of the columella.

After Surgery Table Photos

Photos taken immediately after surgery, frontal view, 45-angle view, and side profile.

Overview

This case is a complex case that simultaneously resolved the structural nose and functional problems that appeared after multiple rhinoplasty surgeries. In particular, it was confirmed that the main cause of nasal congestion and upturned nose was the absence of septal cartilage. Reconstructive surgery using autologous costal cartilage has played a major role in securing structural stability of the nose and improving its functionality. It is thought that septoplasty and submucosal resection of the inferior turbinates can help solve nasal congestion issues and at the same time help improve some of the olfactory function.

The stem cell treatment appears to have had a positive effect in slowing the progression of the contracture, controlling any remaining inflammation, and gently regenerating the hardened skin. This was a great help in improving the contractured condition.

By using a closed rhinoplasty approach, tissue damage was minimized, and the bleeding and damage to blood vessels was minimal, so the risk of inflammation during recovery is expected to be very low. In this regard, the risk of deformation in the future is thought to be very low. Those who are considering rhinoplasty, especially those considering revision surgery, should consult with a specialist to find the method that best suits them. Noselab Clinic will share your concerns and suggest the best solution.

With Noselab Rhinoplasty Clinic you can achieve a beautiful and healthy nose.

Thank you.

Noselab Rhinoplasty Clinic

Dr. Chayoung Kang.