Nasal Contracture Reoperation Using Self-Rib Cartilage – Rhinoplasty Korea

noselab
2024년 7월 29일
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Nasal contracture reoperation is a reconstructive rhinoplasty performed to restore nasal structure and function after inflammation-induced scarring, cartilage loss, and tissue contraction.

In this case, severe contracture and airway obstruction following an infected rib cartilage rhinoplasty were managed through staged stem cell preparation and definitive structural reconstruction using autologous rib cartilage.

Author: Dr. Chayoung Kang, Director, NoseLab Rhinoplasty Clinic

Published: July 29, 2024

Last Updated: January 14, 2026

Hello, I am Dr. Chayoung Kang, Director of NoseLab Rhinoplasty Clinic.

This case involves a patient who developed severe nasal deformity and breathing difficulty after postoperative inflammation following rib cartilage rhinoplasty at another hospital. The initial implant had to be completely removed within two weeks, leaving the nose structurally compromised and functionally impaired.

Patient Condition and Problem Definition

The patient presented with progressive nasal contracture characterized by hardened skin, severe nostril asymmetry, and persistent nasal congestion.

Four months after implant removal, the nasal tip skin had become firm and irregular, with visible contraction pulling the right nostril inward. Due to the risk of further scarring, three rounds of autologous fat-derived stem cell injections were performed to soften the tissue before definitive surgery.

Pre-stem cell treatment frontal, side, and oblique views showing nasal contracture and asymmetry prior to reconstructive rhinoplasty. — Photos taken before stem cell treatment – frontal, side, and 45-degree oblique views

Pre-stem cell treatment nostril view showing nasal contracture and nostril asymmetry prior to reconstructive rhinoplasty. — Nostril view photo taken before stem cell treatment

Functional Evaluation: Nasal Obstruction

The patient complained of significant mouth breathing following the prior surgery.

CT imaging and nasal endoscopy revealed septal deviation, inferior turbinate hypertrophy, and multiple mucosal adhesions inside the nasal cavity. These findings explained the patient’s persistent nasal congestion and indicated that both structural and intranasal correction were required.

Endoscopic photo of the nasal cavity mucous membrane adhesion

Surgical Plan – Nasal Contracture Reoperation

The surgical goal was to restore symmetry, airflow, and long-term stability by reconstructing lost cartilage and releasing contracted soft tissue.

Planned procedures included outer osteotomy for nasal bone asymmetry, septal reconstruction using autologous rib cartilage, alar cartilage binding to correct nostril asymmetry, and controlled lowering of the columella to normalize the alar-columellar relationship. Adhesions inside the nasal cavity were released to improve breathing.

Preoperative frontal design consultation image illustrating nasal midline deviation, nostril asymmetry, and planning for nasal contracture reoperation. — Design consultation photos – frontal

Design consultation photos – profile

Preoperative nostril view design consultation image showing nasal contracture–related nostril asymmetry and planned septal repositioning in nasal contracture reoperation. — [Design consultation photos – nostril

Surgical Outcome: Structural and Functional Recovery

Postoperative evaluation demonstrated clear improvement in nasal shape and airway patency.

From the profile view, the previously blunt and upturned nasal tip was repositioned into a natural angle, and the nasal dorsum gained smooth, stable height. The 45-degree view showed improved nostril width and reduced contracture. From the frontal view, nasal width decreased, columella deviation improved, and nostril asymmetry was significantly corrected.

Before surgery (left), After surgery (right)

Before-and-after 45-degree oblique view demonstrating correction of upturned nasal tip, improved tip projection, and smoother dorsal contour after nasal contracture reoperation with rib cartilage reconstruction. — Before surgery (left), After surgery (right)

Before-and-after frontal view showing improved nasal symmetry, corrected nostril asymmetry, and restored midline alignment after nasal contracture reoperation using autologous rib cartilage. — Before surgery (left), After surgery (right)

Before-and-after nasal base view showing release of contracture, widened nostril aperture, and corrected columella deviation following nasal contracture reoperation using autologous rib cartilage. — Before surgery (left), After surgery (right)

Surgical Table Documentation

Intraoperative and immediate postoperative images confirmed stable cartilage reconstruction and proper alignment of the nasal framework across all angles.

Final Evaluation

Intraoperatively, over 80% of the septal cartilage and the right alar cartilage were found to be absent, requiring complete reconstruction with autologous rib cartilage. While reconstructive procedures may initially appear asymmetric due to swelling, they are essential for preventing long-term deformation and recurrent contracture.

Because this deformity originated from inflammation, postoperative care focused on infection prevention and tissue recovery through antibiotics, hyperbaric oxygen therapy, and laser treatment.

This case demonstrates that staged preparation and structural reconstruction can successfully restore both form and function in patients suffering from severe nasal contracture.