[Nose Lab Clinic]
Hello, this is Dr. Cha-Young Kang, Chief Surgeon at Nose Lab Clinic.
Today, I will share the case of a patient who had been experiencing nasal deformity, pain, and obstruction due to silicone implants that had been in place for 40 years. To restore both function and aesthetics, we performed revision rhinoplasty using rib cartilage reconstruction.
Design Consultation: Frontal View, Left Side View, and Oblique Side View Photos
Design Consultation: Right Side View, Oblique Side View, and Nostril View Photos
1. Surgical History
40 years ago: L-shaped silicone implant insertion
5 years ago: Septal cartilage graft + replacement of silicone implant
2. Patient’s Main Concerns
Right-sided nasal obstruction
Pressing pain along the nasal bridge
Asymmetric nostrils
Deviated columella (tilting to the right)
Overly elevated nasal tip (short nose appearance)
High radix (starting point too high)
3. Patient’s Requests
Moderate nasal height (not excessively high)
Symmetrical nostrils
Slim but rounded nasal tip
Lowered radix for natural proportions
Straightened columella and nasal alignment
4. Surgical Plan and Execution
a. Functional Improvement
Septoplasty to straighten the deviated septum
Radiofrequency turbinoplasty to reduce turbinate hypertrophy (for better airflow)
Rib cartilage reconstruction for septal support and stability
b. Structural Corrections
Straightening the columella to correct its rightward tilt
Balancing nostril asymmetry
Reinforcing nasal septum stability using rib cartilage
c. Aesthetic Enhancements
Stabilizing the over-rotated nasal tip (preventing an upturned nose)
Lowering the radix for a softer, more natural start
Adjusting the nasolabial angle to harmonize with the facial profile
5. Surgical Outcomes
a. Functional Improvements
Significant improvement in nasal breathing
Elimination of nasal bridge pain
Stable structural support
Before (Left) / Immediately After (Right)
b. Frontal View Enhancements
Balanced nostril symmetry
Refined nasal height
A softer and more natural expression
Before (Left) / Immediately After (Right)
c. Side Profile Enhancements
Lowered radix for a more proportionate look
Smooth, natural contour
Improved nasolabial angle, reducing the protrusive mouth appearance
Before (Left) / Immediately After (Right)
d. Nostril Adjustments
Straightened columella (eliminating rightward tilt)
Corrected asymmetry in nostril shape and size
Before (Left) / Immediately After (Right)
6. Expert Insights
Immediately After Surgery: Frontal, Side, and Oblique Side View Photos
Immediately After Surgery: Nostril View Photos
This case highlights the challenges of long-term silicone implants that can lead to deformities, chronic pain, and nasal obstruction. The patient had previously undergone implant replacement, but the symptoms persisted. By removing the implant entirely and reconstructing the nasal structure using rib cartilage, we were able to:
Restore structural stability
Correct the nasal asymmetry
Alleviate chronic nasal pain
Improve breathing function
Achieve a natural, refined aesthetic outcome
Most notably, the realignment of the columella and nostrils contributed to both functional and cosmetic improvements, fulfilling the patient's desire for a slim yet naturally rounded nasal tip.
This is Dr. Cha-Young Kang, Chief Surgeon at Nose Lab Clinic.
Thank you.
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