Correction of Graft Resorption and Nasal Scar Irregularity – Autologous Rib Cartilage Reconstruction Case Study

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

Today I’d like to share a complex reconstructive case where we addressed multiple complications caused by graft resorption and dorsal scarring using autologous rib cartilage.

Design Consultation: Frontal View, Left Side View, and Oblique Side View Photos

📍 Surgical History

• First surgery: Grafted rib cartilage, which later caused inflammation

• 2018: Silicone implant + auricular cartilage + donor rib cartilage

Design Consultation: Right Oblique Side View, Side View, and Nostril View Photos

🔎 Initial Findings

Issues from Graft Resorption

• Tip shrinkage

• Nose shortened over time

Structural Concerns

• Collapsed, pinched alar cartilages

• Drooping nasal tip

• Overexposed nostrils

• Asymmetric nostrils

• Increased columellar-labial angle (over-rotation appearance)

Skin Problems

• Dorsal surface irregularity due to scarring

• Thinned dermal tissue from prior resurfacing procedures

• Redness at nasal tip due to vascular compromise

✨ Patient’s Goals

• Correct deformities from donor cartilage resorption

• Improve pinched appearance of the alae

• Smooth out dorsal surface

• Achieve a more natural nasal contour

💉 Surgical Approach

Structural Reconstruction

• Septal extension using autologous rib cartilage

• Rebuilding bilateral alar cartilages with rib grafts

• Correction of pinched alae

• Columellar-labial angle adjustment

Surface Refinement

• Smoothing dorsal irregularity using a combination of cartilage and dermal grafts

• Precise handling of scarred areas to restore smooth surface

Overall Contour Enhancement

• Augmenting the shrunken nasal tip

• Restoring appropriate nasal length

• Elevating and reshaping the drooping tip

• Correcting the over-rotated appearance

✅ Surgical Results

Before (Left) / Immediately After (Right)

Frontal View

• Natural correction of previously pinched alae

• Properly restored nasal tip volume

• Balanced nostril shape

• Smoother dorsal surface

Before (Left) / Immediately After (Right)

Profile View

• Recovered nasal length

• Elevated and defined tip

• Improved columellar angle

• Corrected rotation

Before (Left) / Immediately After (Right)

Overall

• Natural and refined nasal shape

• Harmonized facial proportions

• Stable and durable structural outcome

Before (Left) / Immediately After (Right)

👨‍⚕️ Surgeon’s Commentary

Immediately After Surgery: Frontal, Side, and Oblique Side View Photos

Immediately After Surgery: Nostril View Photo

This case involved a patient who previously experienced inflammation after a grafted rib cartilage procedure and subsequently underwent multiple surgeries. Over time, the donor cartilage resorbed, resulting in tip shrinkage, a shortened nose, pinched alae, overexposed and asymmetric nostrils, and significant dorsal scarring.

support at the tip and nasal base. To address this comprehensively, we opted for total reconstruction using autologous rib cartilage, known for its long-term stability and minimal resorption risk.

We rebuilt the alar cartilages and reinforced the septum with rib cartilage, correcting the pinched appearance and restoring proper length and projection to the nasal tip. Columellar-labial angle correction helped resolve the over-rotated, upturned appearance of the nose.

The dorsal scarring, one of the most visible aesthetic concerns, was addressed using a precise combination of cartilage and dermal grafts, producing a smooth, natural surface—something difficult to achieve with standard implants alone.

This case highlights the value of autologous reconstruction in complex secondary rhinoplasty, particularly when previous graft materials have failed. By restoring structure with the patient’s own tissue, we achieved both aesthetic harmony and long-term durability—an outcome the patient can confidently rely on.

Thank you,Dr. Cha-Young KangNose Lab Clinic

https://blog.naver.com/cykang/223871735115