Foreign Body Reaction Rhinoplasty with Septal Reconstruction
- Dr. Chayoung Kang
- 2025년 4월 8일
- 6분 분량
This case reviews foreign body reaction rhinoplasty in a patient with chronic inflammatory response, serous fluid accumulation, septal cartilage damage, bulbous nasal tip, excessive nostril exposure, nostril asymmetry, deviated columella, nasal bridge widening, and functional airway compromise after orthognathic surgery and previous nasal procedures. Surgery focused on inflamed tissue removal, serous fluid drainage, irrigation, rib cartilage septal reconstruction, tip and columella correction, dorsal refinement, nostril symmetry correction, airway support, and closed rhinoplasty structural reconstruction.
Author: Dr. Cha-Young Kang
Clinic: NoseLab Clinic
Published: 2025
Last Updated: 2026
Introduction
Hello, this is Dr. Cha-Young Kang of NoseLab Clinic.
This case involves foreign body reaction rhinoplasty in a patient who developed chronic inflammation, septal cartilage damage, and nasal deformity after orthognathic surgery and multiple previous nasal procedures.
Persistent inflammatory response led to serous fluid accumulation, weakening of nasal support, and distortion of the nasal framework. The patient also had nostril asymmetry, excessive nostril exposure, deviated columella, and functional airway compromise.
The surgery was performed using a closed rhinoplasty / endonasal approach. The goal was to address the source of inflammation, remove inflamed tissue where identified, reconstruct the damaged septal support with rib cartilage, improve nostril balance, and support the nasal airway.
Case Background
The patient presented with chronic foreign body reaction and nasal structural distortion after previous facial and nasal procedures.
In cases involving persistent inflammation, the priority is not simple cosmetic refinement. The source of irritation, damaged support structures, and airway function must be evaluated together.
Key Concerns
The main concerns included:
Chronic foreign body reaction
Persistent inflammatory response
Serous fluid accumulation
Septal cartilage damage
Bulbous nasal tip
Excessive nostril exposure
Nostril asymmetry
Deviated columella
Widened nasal bridge
Functional airway compromise
These findings suggested that the case required inflammatory tissue management and structural reconstruction rather than simple contour correction.
Why Foreign Body Reaction Rhinoplasty Was Needed
Chronic foreign body reaction may occur when implanted or retained material contributes to persistent inflammation within the nasal structure.
In more severe cases, inflammation can lead to tissue damage, cartilage weakening, fluid accumulation, and distortion of the nasal framework.
In this case, the septal cartilage had been damaged, and the nasal support structure had become weakened. For this reason, rib cartilage septal reconstruction was included in the surgical plan.
Because the patient also had functional airway compromise, airway support was considered together with external nasal correction.
Preoperative Structural Assessment
Preoperative design consultation photos were reviewed from the frontal, side, oblique, and nostril views.
Frontal View
The frontal view showed a widened nasal bridge, bulbous nasal tip, and asymmetry of the lower nasal structure.
Inflammation-related swelling and structural distortion were considered during the surgical planning.
Side View
The side view showed imbalance of the nasal bridge, radix, and tip position.
The nasal tip and columella position required correction together because the lower nasal framework had been affected by structural weakening.
Oblique View
The oblique view showed nasal bulkiness and contour irregularity related to inflammation and previous surgical changes.
Nostril View
The nostril view showed nostril asymmetry and columella deviation.
These findings suggested that lower nasal reconstruction and nostril symmetry correction were necessary.
Surgical Plan
The surgical plan included foreign body reaction management, septal reconstruction, tip and columella correction, dorsal refinement, nostril correction, and airway support.
1. Foreign Body Reaction Management
Inflamed capsule tissue was removed where identified.
Serous fluid was drained, and irrigation was performed to reduce inflammatory burden.
In cases involving chronic inflammation, tissue condition should be evaluated carefully because the degree of inflammation and damage can vary.
2. Rib Cartilage Septal Reconstruction
Rib cartilage was used to reconstruct the damaged septal support.
Because septal cartilage loss can weaken the central nasal framework, reconstruction was needed to support the nasal tip, columella, and airway structure.
3. Tip and Columella Correction
The upturned nasal tip was corrected through structural support and repositioning.
The deviated columella was repositioned to improve lower nasal balance and nostril symmetry.
4. Dorsal Refinement
The bulky nasal bridge was refined to improve the dorsal contour.
The goal was to reduce excessive bridge width and improve the transition between the nasal bridge and tip.
5. Nostril Symmetry Correction
Nostril asymmetry was corrected as part of the lower nasal reconstruction.
Because nostril shape is influenced by the septum, columella, alar support, and scar tissue, these structures were evaluated together.
6. Functional Airway Support
Airway support was included because the patient had functional airway compromise.
The reconstructed septal framework helped support both the external nasal structure and internal airway.
Surgical Results
Frontal View
From the frontal view, the nasal bridge appeared slimmer after inflammatory tissue management and dorsal refinement.
Inflammation-related swelling appeared reduced, and symmetry improved after structural reconstruction.
Lateral View
From the lateral view, the radix and nasal tip position appeared more balanced after reconstruction.
The nasal profile appeared smoother after tip and dorsal contour correction.
Oblique View
From the oblique view, nasal bulkiness was reduced, and the nasal contour appeared more balanced.
Nasal Base View
From the nasal base view, nostril symmetry improved after columella repositioning and lower nasal framework support.
The columella appeared straighter after structural correction.
Functional Outcome
Airway support was addressed through septal reconstruction and structural correction.
Because breathing changes depend on internal anatomy, inflammation control, swelling, scar tissue, and healing response, functional improvement should be evaluated over time.
Surgeon’s Commentary
Chronic foreign body reaction can affect both nasal structure and function. In these cases, simply improving the outer nasal shape is not enough.
When persistent inflammation, serous fluid accumulation, and septal cartilage loss are present, the surgical plan should first address the inflammatory tissue and damaged framework.
In this case, inflamed capsule tissue was removed where identified, serous fluid was drained, and irrigation was performed.
Because the septal cartilage was severely damaged, rib cartilage was used for septal reconstruction. This provided structural support for the nasal tip, columella, and airway.
Tip position, columella deviation, nostril asymmetry, and bridge bulkiness were corrected together because the deformity involved multiple parts of the nasal framework.
This case shows that foreign body reaction rhinoplasty should be planned as a combined inflammation-management, septal reconstruction, nostril correction, dorsal refinement, and airway-support procedure.
FAQ
What causes foreign body reaction after rhinoplasty or facial surgery?
Foreign body reaction may occur when the body reacts to implanted or retained material. This can lead to inflammation, swelling, fluid accumulation, tissue irritation, or structural changes.
Can foreign body reaction be treated without surgery?
Mild inflammation may sometimes be managed medically, but cases involving chronic inflammation, fluid accumulation, structural damage, or airway compromise may require surgical evaluation.
Why is rib cartilage used for septal reconstruction?
Rib cartilage may be used when septal cartilage is damaged or insufficient. It can help rebuild the central support structure and support the nasal tip, columella, and airway.
Can breathing improve after septal reconstruction?
Breathing may improve when septal support, airway narrowing, or structural compromise is corrected. The degree of improvement depends on airway anatomy, inflammation, swelling, and healing.
Is closed rhinoplasty possible in foreign body reaction cases?
A closed rhinoplasty / endonasal approach may be used in selected cases, depending on the location of inflammation, scar tissue, structural damage, and reconstruction needs.
International Consultation
For international patients, a photo-based consultation may help clarify whether foreign body reaction rhinoplasty, rib cartilage septal reconstruction, inflamed tissue removal, nostril correction, dorsal refinement, or airway support may be needed.
WhatsApp: https://wa.me/821057360302
LINE: [LINE Link]
Medical Disclosure
Surgical before-and-after photos show individual patient cases, and results may vary depending on each patient’s anatomy, foreign body reaction, inflammation, implant history, scar tissue, septal cartilage damage, airway structure, tissue condition, and healing process. Please consult your doctor for an individualized assessment.
After surgery, complications may occur, including infection, bleeding, allergic reaction, recurrent inflammation, fluid accumulation, asymmetry, limited aesthetic or functional improvement, excessive scarring, skin problems, necrosis, graft visibility, cartilage warping, persistent nasal obstruction, contour irregularity, or other complications.
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