Hello, this is Dr. Cha-Young Kang, Director of Nose Lab Clinic.
Today, I’m sharing a case involving a 22-year-old male patient who experienced nasal contracture and deformity after multiple rhinoplasty procedures. This case highlights the risks associated with repeated nasal surgeries and the importance of safe, reconstructive approaches in achieving stable and natural results.
Design Consultation: Frontal View, Left Oblique Side View, and Side View Photos
1. Patient’s Surgical History and Requirements
Surgical History:
2022: Cheekbone and jaw reduction surgery
2023: Septal and ear cartilage grafting with implant-free nostril reduction
2023: Revision surgery using autologous rib cartilage
2024: Nasal cartilage graft and implant-free surgery, followed by inflammation one week post-surgery requiring medication
Patient Goals:
Correct asymmetry in the nostrils
Improve overall nasal shape and structure
2. Pre-Surgical Assessment
Design Consultation: Right Side View, Oblique Side View, and Nostril View Photos
Front View:
Visible nostril asymmetry
Noticeable nasal deviation
Side View:
Low nasal bridge
Short, upturned nasal tip
Nostril View:
Columella tilted to the left, with asymmetric nostrils
Given the inflammation from previous surgeries, a recovery period with stem cell treatment was recommended, and surgery was scheduled approximately three months later for optimal healing.
3. Surgical Plan
To address the patient’s structural and aesthetic concerns, we planned the following approach:
Lateral Osteotomy: Correcting the deviated bridge.
Autologous Rib Cartilage Reconstruction: Rebuilding the nasal bridge and tip without implants to ensure durability and biocompatibility.
Septal Reconstruction: Repairing severe septal damage from prior surgeries.
Nasolabial Angle Correction: Aligning the nose and upper lip to create a natural profile.
4. Post-Surgical Results
Before (Left) / Immediately After (Right)
Side View:
The previously uneven, low bridge was corrected for a smoother, natural profile.
Nasolabial angle correction improved upper lip projection.
Before (Left) / Immediately After (Right)
Oblique View:
The shortened, bulbous nasal tip was refined, achieving greater definition.
The previously low nasal bridge now appears proportionally elevated.
Before (Left) / Immediately After (Right)
Front View:
Significant improvement in nasal symmetry and alignment.
Reduced nostril visibility and asymmetry.
Before (Left) / Immediately After (Right)
Nostril View:
Corrected leftward tilt of the columella.
Notable symmetry in nostril shape and size.
5. Understanding Implant-Free Rhinoplasty
Implant-free rhinoplasty uses bio-tissues like cartilage or dermis instead of synthetic materials such as silicone or Gore-Tex. Here’s an overview of the pros and cons:
Pros:
Lower risk of infection
More natural feel and appearance
Cons:
Less predictable aesthetic outcome
May offer limited contouring options compared to implants
In this case, using autologous rib cartilage provided a robust foundation, reducing risks associated with synthetic implants.
Final Thoughts
Frequent nasal surgeries can lead to serious complications, particularly in cases of contracture. For patients considering revision rhinoplasty, it is crucial to take adequate time for recovery between procedures and choose a method that prioritizes safety and stability. Consulting with an experienced specialist is key to finding a tailored approach that meets individual needs.
At Nose Lab Clinic, we are committed to providing safe, effective, and personalized care. If you have questions, please feel free to comment—we’re here to help.
Thank you,
Dr. Cha-Young Kang, Director of Nose Lab Clinic
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