Correction of Nasal Obstruction Caused by Alloplastic Implant Protrusion After Augmentation Rhinoplasty
- noselab
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Hello, this is Dr. Cha-Young Kang, Medical Director at Nose Lab Clinic.
Today, Iโm sharing a complex reconstructive case involving a patient who experienced severe nasal obstruction due to a protruding alloplastic implant following an earlier augmentation rhinoplasty ("gwijok" surgery), which significantly affected both breathing and aesthetics.
๐ Surgical History
Design Consultation: Frontal View, Left Side View, and Oblique Side View Photos
2010: Primary rhinoplasty including nasal base reduction and augmentation rhinoplasty
2012: Septal reconstruction + silicone implant + donor rib cartilage (DR)
2013: Nasal valve repair + triple functional procedures
Design Consultation: Right Oblique Side View, Side View, and Nostril View Photos
๐ Initial Assessment
Nasal Endoscopy Photos
Severe Functional Issues
Right-sided nasal implant had migrated into the nasal cavity, blocking approximately two-thirds of the airway
Complete obstruction of the right nasal passage
Ongoing allergic rhinitis symptoms
Structural Damage
Severely compromised septum
Columella collapse
Significant bilateral alar cartilage damage
Pinched nasal alae appearance
Aesthetic Concerns
Deviated nasal axis
Drooping nasal tip
โจ Patient Goals
Correct deviated nose
Elevate drooping nasal tip
Resolve intranasal obstruction and improve breathing
๐ Surgical Strategy
Functional Restoration
Removed the obstructive implant from the nasal cavity
Removed remaining augmentation (gwijok) implants to prevent future issues
Structural Reconstruction
Rebuilt the septum using autologous rib cartilage
Reconstructed both alar cartilages with rib cartilage to correct the pinched appearance
Restored collapsed columella
Aesthetic Refinement
Straightened the deviated nasal bridge
Elevated the nasal tip
Corrected the nasolabial angle
Improved alar shape for a natural contour
Functional Enhancement
Septoplasty and submucosal resection of inferior turbinates using radiofrequency to improve nasal airflow and relieve rhinitis symptoms
โ Surgical Outcomes
Functional Recovery
Obstruction in right nasal passage resolved
Bilateral nasal breathing normalized
Rhinitis symptoms significantly reduced
Before (Left) / Immediately After (Right)
Frontal View
Straightened nasal axis
Naturally restored alar shape
Corrected pinched appearance
Balanced nasal contour
Before (Left) / Immediately After (Right)
Profile View
Enhanced nasal tip projection
Restored columella support
Corrected nasolabial angle
Harmonious side profile
Before (Left) / Immediately After (Right)
Structural Stability
Strongly reconstructed septum
Durable alar support with autologous grafts
Long-term stability ensured
Before (Left) / Immediately After (Right)
๐จโโ๏ธ Specialist Commentary
Immediately After Surgery: Frontal, Side, and Oblique Side View Photos
Immediately After Surgery: Nostril View Photo
This case was particularly challenging due to a rare complication: migration of a prior augmentation rhinoplasty implant into the nasal cavity. This resulted in almost complete obstruction of the right nasal airway, causing significant discomfort and respiratory distress.
Over time, changes in soft tissue and weakened implant fixation likely contributed to the migration. Simultaneously, multiple prior surgeries had caused severe structural damage, including a weakened septum, damaged alar cartilages, and columella collapse.
The first priority was functional restoration. We carefully removed the dislocated implant and additional augmentation implants to prevent future displacement. Structural reconstruction was then performed using autologous rib cartilage to rebuild the septum and both alar cartilages, restoring support and symmetry.
The drooping tip was lifted, the deviated bridge realigned, and the collapsed columella reconstructed. These corrections were carried out in conjunction with functional nasal surgeries to enhance breathing and reduce rhinitis symptoms.
By combining detailed structural repair with functional and aesthetic refinement, this case demonstrates how complex complications from prior surgeries can be effectively corrected using autologous grafts. The outcome is not only a more harmonious nasal appearance but also restored breathing and long-term anatomical stability.
Thank you,
Dr. Cha-Young Kang
Director, Nose Lab Clinic
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