Nasal Skin Necrosis Reconstruction in Korea After Multiple Surgeries
- Dr. Chayoung Kang
- 2025년 5월 26일
- 5분 분량
최종 수정일: 5월 8일
This case reviews nasal skin necrosis reconstruction in Korea for a patient with severe nasal skin thinning, vascular compromise, scarring, nostril asymmetry, and structural weakness after multiple previous surgeries. The surgical plan focused on careful dissection, autologous rib cartilage support, alar cartilage repositioning, and functional airway correction.
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 nasal skin necrosis reconstruction in a patient who developed severe nasal skin damage, vascular compromise, scarring, and nostril asymmetry after multiple nasal surgeries over approximately 15 years.
The surgery was performed using a closed rhinoplasty / endonasal approach. The main goal was to protect the remaining blood supply, rebuild weakened nasal support, improve nostril shape, and address functional breathing problems.
Surgical History Leading to Nasal Skin Necrosis
The patient had a long surgical history involving silicone implants, implant removal, cartilage grafts, dermal grafts, infection-related revision, skin resurfacing, and facial skeletal surgery.
Previous Surgical and Treatment History
The patient’s previous procedures included:
15 years ago: Silicone implant rhinoplasty
10 years ago: Implant removal, ear cartilage graft, and alar base reduction
9 years ago: Repeat grafting, infection, and removal
Later: AlloDerm insertion and gluteal dermis graft
Multiple resurfacing procedures, including chemical peels, causing additional skin thinning
5 years ago: Autologous rib cartilage and dermis graft
6–7 years ago: Upper lip lift and two-jaw surgery
After repeated procedures, inflammation, and skin resurfacing, the nasal skin became thin and vulnerable. The nasal tip and dorsum showed signs of scarring, discoloration, vascular compromise, and contour irregularity.
Nasal Skin Necrosis Symptoms and Nostril Asymmetry
Preoperative evaluation showed that the patient’s concerns were not limited to nasal shape. The case involved compromised skin quality, weakened structure, dense scar tissue, and nostril deformity.
Skin and Soft Tissue Findings
The main skin and soft tissue findings included:
Irregular nasal dorsum with scarring
Thinned and discolored nasal skin after necrosis
Redness of the nasal tip suggesting vascular compromise
Dense fibrotic tissue from repeated graft failure and inflammation
Reduced skin flexibility due to previous surgery and resurfacing
Structural and Nostril Findings
The structural findings included:
“^ ^” shaped nostrils
Drooping alar rims
Alar base height asymmetry
Nostril asymmetry
Weakened nasal support
Irregular dorsal contour
In nasal skin necrosis cases, aggressive dissection can increase the risk of additional vascular injury. For this reason, the surgical plan had to prioritize tissue preservation and controlled reconstruction.
Customized Plan for Nasal Skin Necrosis Correction Korea
The surgical plan for nasal skin necrosis correction Korea focused on structural rebuilding while preserving the remaining vascular supply. The goal was not excessive reshaping, but stable reconstruction within safe tissue limits.
Autologous Rib Cartilage Reconstruction
Autologous rib cartilage was used to rebuild the weakened nasal structure and improve dorsal contour. Rib cartilage provided the support needed in a case where previous procedures had weakened the nasal framework.
Extended Septal Support
Extended septal support was used to reinforce the central nasal structure. This helped support the weakened nasal tip and improve overall nasal stability.
Conservative Dissection to Preserve Blood Supply
Because the nasal skin had already been compromised, dissection was performed conservatively. Preserving the remaining blood supply was essential to reduce the risk of further skin damage.
Vascular Recovery Support
Concentrated growth factor support was used to assist tissue recovery. In cases with vascular compromise, soft tissue recovery support may be considered as part of the reconstruction strategy.
Alar Cartilage Repositioning
The alar cartilages were repositioned to improve nostril shape and alar rim position. The goal was to reduce the “^ ^” nostril appearance and improve symmetry without placing excessive tension on the skin.
Functional Airway Correction
Septoplasty and turbinate reduction were performed to improve nasal airflow. This allowed the surgery to address both external nasal reconstruction and internal breathing function.
Aesthetic and Functional Goals
The surgical goals were planned around both appearance and function.
The main goals included:
Smoother nasal bridge contour
Improved alar base height symmetry
More natural nostril shape
Improved nasolabial angle
Better columella-lip relationship
Improved breathing through septoplasty and turbinate reduction
Stable reconstruction with reduced tissue stress
Because the patient had a history of nasal skin necrosis and vascular compromise, every correction had to be balanced against the condition of the remaining skin and soft tissue.
Results of Nasal Skin Necrosis Reconstruction in Korea
Frontal View
From the frontal view, the nasal dorsum appeared smoother, and the overall nasal contour became more balanced. The nostril shape also showed improvement after structural support and alar cartilage repositioning.
Side View
From the side view, the dorsal projection appeared more stable, and the nasolabial angle improved. The relationship between the columella and upper lip became more proportionate.
Nostril View
From the nostril view, the alar rims were repositioned, and the “^ ^” nostril appearance was reduced. The nostrils appeared more stable and better supported after reconstruction.
Functional Outcome
Breathing function improved after septoplasty and turbinate reduction. Functional correction was important because the patient had both external deformity and internal airway concerns.
Surgeon’s Commentary on Nasal Skin Necrosis Reconstruction
This was a complex revision rhinoplasty case involving nasal skin necrosis, vascular compromise, scarring, nostril asymmetry, and multiple previous surgeries over approximately 15 years.
The most important point was tissue safety. When nasal skin has been damaged by necrosis, repeated surgery, infection, or resurfacing, the remaining blood supply may be limited. In this situation, excessive dissection or overly aggressive correction can create additional risk.
Autologous rib cartilage was used to rebuild the weakened nasal framework. However, in a skin-compromised case, strong support alone is not enough. The cartilage must be shaped and positioned carefully so it does not place unnecessary pressure on the thin nasal skin.
The nostril deformity was also related to previous surgery, scarring, and alar rim instability. Alar cartilage repositioning helped improve the nostril shape and alar base balance within a realistic and safe range.
This case shows that nasal skin necrosis reconstruction should be planned as a combined vascular, structural, and functional reconstruction. The goal is to protect compromised tissue, rebuild support, improve nostril shape, and restore breathing function without creating excessive tension.
— Dr. Chayoung Kang
Medical Director, NoseLab Clinic
FAQ
Why is nasal skin necrosis reconstruction difficult?
Nasal skin necrosis reconstruction is difficult because the skin and soft tissue may have reduced blood supply. Surgery must protect the remaining vascular supply while rebuilding nasal support.
Can rib cartilage be used for nasal skin necrosis correction Korea?
Yes, rib cartilage can be used when the nasal framework is weak or previously damaged. In nasal skin necrosis correction Korea, cartilage must be positioned carefully to avoid pressure on compromised skin.
How does nostril asymmetry occur after multiple nasal surgeries?
Nostril asymmetry can occur from scarring, alar cartilage displacement, alar base surgery, or tissue contraction. Correction requires structural support and careful repositioning rather than simple skin tightening.
International Consultation
For international patients, a photo-based consultation may help clarify whether nasal skin necrosis reconstruction, alar correction, rib cartilage support, or functional correction may be needed.
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