Complete Illegal Filler Removal and Total Septal Reconstruction Using Autologous Rib Cartilage

Hello,

This is Dr. Cha-Young Kang, board-certified plastic surgeon and medical director of NOSELAB Plastic Surgery Clinic.

Today, I’d like to share a complex revision rhinoplasty case involving a patient who had undergone illegal filler injections (commonly known as “back-alley fillers”) in the nasal bridge and required complete illegal filler removal and total septal reconstruction using autologous rib cartilage. The surgery aimed to restore nasal structure, correct deformities, and ensure long-term tissue safety.

Surgical Approach to Complete Illegal Filler Removal and Septal Reconstruction

Preoperative design consultation photos: Frontal view, left oblique side view, and left side view.

Past Surgical History:

• 9 years ago: Primary rhinoplasty using silicone implant and septal cartilage

• 4–5 years ago: First revision rhinoplasty

• Later: Received unauthorized nasal filler injections

Preoperative design consultation photos: Right side view, right oblique side view, and nostril view.

Patient Concerns:

• Anxiety and discomfort caused by unknown filler substances

• Unnatural nasal contour and stiffness

• Skin tightness and fibrosis due to chronic inflammation

• Desire for a natural, stable, and healthy nasal structure

1. Complete Illegal Filler Removal

We carefully removed all illegal filler materials injected into the nasal bridge.

These substances often lead to chronic inflammation, fibrosis, deformity, and migration over time.

Complete illegal filler removal is therefore essential to prevent future infection or necrosis and to restore natural contours.

2. Septal Condition Assessment

Following multiple surgeries, almost no viable septal cartilage remained.

Without this internal pillar, the nose collapses structurally.

We decided on a total septal reconstruction to restore support and maintain the nasal shape.

3. Total Septal Reconstruction Using Autologous Rib Cartilage

The patient’s own rib cartilage was harvested and shaped to rebuild the entire septum.

Autologous cartilage provides strong, biocompatible, and long-term stability — ideal for severe revision cases after illegal filler removal or implant complications.

4. Managing Damaged Skin and Depleted Cartilage After Illegal Filler Removal

The patient’s nasal skin had been thinned and contracted from prior filler injections and surgeries.To safely reconstruct the nose:

• Dermal grafts were applied to reinforce fragile skin

• Scar tissue and adhesions were released to improve flexibility

• Tip projection was kept conservative to prevent skin tension

This careful balance helped preserve skin integrity while maintaining a natural shape.

5. Structural Nasal Framework Reconstruction

reshaped the alar cartilage for balance and symmetry.

Our focus remained on safe, stable, and long-lasting correction, rather than exaggerated projection.

Surgical Outcome After Illegal Filler Removal

Before Surgery (Left) / Immediately After Surgery (Right)

Frontal View:

• Smooth, natural nasal bridge restored

• Defined but stable nasal tip

• Overall facial balance improved

Before Surgery (Left) / Immediately After Surgery (Right)

Lateral View:

• No dorsal irregularities

• Proper nasolabial angle and tip rotation

• Natural contour maintained without tension

Before Surgery (Left) / Immediately After Surgery (Right)

Base (Nostril) View:

• Balanced and symmetrical nostrils

• Columella aligned to midline

• Stable nasal base achieved

Before Surgery (Left) / Immediately After Surgery (Right)

Expert Insights on Safe and Systematic Illegal Filler Removal

1. The Hidden Dangers of Illegal Filler Injections

Unauthorized fillers can cause chronic inflammation, infection, and severe deformities.

They migrate unpredictably and often harden over time, making illegal filler removal highly complex.

Leaving them untreated increases the risk of skin necrosis and permanent scarring.

2. Total Reconstruction with Autologous Rib Cartilage

When septal cartilage is depleted, rib cartilage reconstruction becomes the most effective solution.

It ensures internal stability and long-term biocompatibility, crucial after multiple failed or unsafe procedures.

3. Staged and Conservative Surgical Planning

We prioritize safety, not speed.

Instead of overcorrecting in one surgery, we restore stability first and allow full healing before considering refinements.

This staged method minimizes complications and ensures durable results.

Final Thoughts

This case highlights the importance of timely illegal filler removal and safe structural reconstruction.

Unapproved injections using unknown substances can cause irreversible tissue damage.

Always seek treatment at licensed clinics using FDA or KMFDA-approved materials.

At NOSELAB, we focus on:

✅ Accurate diagnosis and safety-first planning

✅ Complete removal of foreign materials

✅ Structural stability through autologous tissue

✅ Natural, functional, and long-term aesthetic results

If you are suffering from complications due to fillers or previous surgeries, don’t wait—consult a qualified specialist.

Thank you for reading. – Dr. Cha-Young Kang,

Postoperative precautions and possible complications after rhinoplasty

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