Pinched Nasal Tip Correction After Medpor Removal – Complex Revision Rhinoplasty

By Dr. Cha-Young Kang | Nose Lab Clinic

Surgical Background and Patient History

This case involves a complex revision rhinoplasty focused on pinched nasal tip correction, columella lengthening, and structural reconstruction using autologous rib cartilage. The patient had undergone three previous rhinoplasties over 15 years, resulting in significant cartilage depletion and tissue contracture.

Design Consultation: Frontal View, Left Side View, and Oblique Side View Photos

Surgical History

• 15 years ago: Silicone implant + ear cartilage graft

• 7 years ago: Revision with silicone + ear cartilage

• 5 years ago: Further revision, likely involving septal cartilage (uncertain)

Initial Assessment – Why Pinched Nasal Tip Correction Was Needed

Design Consultation: Right Side View, Oblique Side View, and Nostril View Photos

Frontal View Findings

• Narrowed and pinched alar base

• Retracted, shortened columella

• Drooping nasal tip

• Flattened nasal bridge

Side View Findings

• High nasal radix

• Bulbous nasal tip

• Poor columella visibility

Functional Symptoms

• Nasal obstruction

• Chronic rhinitis

Deviated Nasal Septum and Hypertrophic Rhinitis Observed via Nasal Endoscopy

Surgical Goals – What the Patient Wanted

• Correct the pinched nasal tip and restore nasal shape

• Create a slim, defined nasal line without elongating the nose

• Lower the columella naturally for visible projection

• Maintain balance and avoid an overdone look

Surgical Plan and Intraoperative Findings

Unexpected Medpor Discovery

• Medpor implant was found inside the columella and removed

• Contracted scar tissue around the tip was excised

• Severe cartilage loss confirmed in the alar region

Photos of Removed Silicone Implant, Foreign Materials, and Medpor

Reconstructive Strategy

• Used autologous rib cartilage for pinched nasal tip correction

• Rebuilt the overused septum and restored tip support

• Lowered radix height to soften facial balance

• Improved columella projection and nostril shape

Postoperative Results – Pinched Nasal Tip Resolved

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

Frontal View

• Noticeable improvement in alar base width

• Columella and tip project downward naturally

• Narrower but more defined nasal bridge

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

Side View

• Natural nasofacial profile

• Eliminated droopiness at the tip

• Harmonious nasolabial angle

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

Nasal Base View

• Nostril symmetry improved

• Alar rims reshaped and filled

• Stronger columellar structure

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

Functional Outcome

• Corrected deviated septum

• Inferior turbinate size reduced

• Nasal airflow and breathing greatly improved

Surgeon’s Insight – Managing Severe Pinching and Cartilage Loss

Immediately after surgery: Frontal view, side view, and oblique side view photos.

Immediately after surgery: Nostril view photos.

This patient had a severely pinched nasal tip due to prior over-resection and scarring. Through careful Medpor removal and autologous rib cartilage grafting, we achieved both structural stability and aesthetic refinement.

The key was restoring nasal definition while preserving a natural length. The result is a more elegant and breathable nose, free from previous asymmetry and pinching.

Thank you for reading.

– Dr. Cha-Young Kang, Nose Lab Clinic

At NOSELAB, all surgeries are performed using the closed (endonasal) technique.

Postoperative precautions and possible complications

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