Secondary Surgery for Contractured Nose: Refining Shape and Function

noselab
2024년 6월 21일
3분 분량

최종 수정일: 10월 2일

Hellol! I am Dr. Chayoung Kang, the director of Noselab Clinic

Today, I will introduce a case of contractured nose secondary surgery. The patient had undergone severe contracture correction with autologous rib cartilage in the primary surgery, and this time wanted a more refined and natural nose shape through a delicate secondary surgery.

Preoperative Design After Contracture Correction

After the first surgery for contracture, the crushed nose tip and pine appearance had improved, however, the nose tip looked slightly droopy and the heigh of the glabella was not satisfactory enough, so we planned to elevate the nose tip and reorganized the line of the nose bridge for this surgery

Surgical Plan for Contractured Nose Secondary Surgery

The plan is to reinforce the cartilage at the nose tip to help its height, and lower the columella slightly to correct the nasolabial angle to look more natural. Also, since this patient had received several open rhinoplasty surgeries in the past, the columella had a scar and a lot of hard scar tissue that lowered the columella, but it was predicted that the skin would not be enough, so we planned to mae a compound transplant of skin and dermis to reconstruct the insufficient skin.

Before and After surgery photos

From the side view profile, we can observe that the nose tip surely became more refined and the appearance of the columella became more natural-looking.

Before surgery (left), after surgery (right)

In the 45-degree angle view, we can see the continuous line from the nose tip to the nose bridge changed to have a more femenine look.

From the dront, we can see that before, the columella was on a upper area above the alar, so the columella was lowered until the alar line to give it a natural appearance.

By seeing the nostril photos, we can see that the open rhinoplasty at the previous hospital resulted in a retracted columella and that there was a scar on the columella, so we performed a skin transplant to make it look smoother.

After surgery photos

Photos after the surgery. 90° angle | 45° angle | Frontal view

My thoughts in regards to a secondary corrective surgery for a contractured nose.

Every surgery aims to be the last in the first place, but sometimes we cannot catch two rabbits at the same time. Severe contracture surgery is like this sometimes. If the cartilage inside the nose is severely damaged, if the skin cannot be stretched enough, if it does not have enough strenght, or if there is still acute inflammation present, it is a case where we have to plan a secondary procedure.

In other words, the primary surgery aims to reconstruct severely damaged tissue inside of the nose (septal cartilage, alar cartilage (lower cartilage), upper and lateral cartilage, nasal bone), and working on the foundation of a sturdy structure that can withstand the buildup of the skin or surgery to remove the accute inflammation and minimize the nose tip deformation, and a cosmetic surgery after 3 to 6 months.

Today we talked about a case of a secondary surgery of a contracture nose to make it more natural-looking and beautiful. I hope this text is helpful for those who are considering to get a contractured nose revision surgery.

Dr. Chayoung Kang

Director of Noselab Clinic