Rib Cartilage Nose Reconstruction: Resolution of Septal Perforation and Complex Nasal Tip Issues After 14 Years [Nose Lab Clinic]

Key Case of Rib Cartilage Nose Reconstruction in Korea

Hello, this is Dr. Cha-Young Kang, Medical Director at Nose Lab Clinic.

Today, I’d like to share the story of a patient who successfully underwent comprehensive reconstruction using autologous rib cartilage after experiencing repeated surgeries and chronic inflammation over a span of 14 years.

## Surgical History of Rib Cartilage Nose Reconstruction

📍 Surgical History

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

14 Years Ago

• Gore-Tex implant + ear cartilage graft

13 Years Ago

• Silicone implant + alar base reduction + osteotomy

12 Years Ago

• Implant removal from glabella due to inflammation

10 Years Ago

• Filler injected along the nasal dorsum and tip after implant removal

9 Years Ago

• Filler removal, silicone implant + ear cartilage + repeated alar base reduction

Most Recently

• Silicone implant + ear cartilage

• Tip augmentation with gluteal dermis

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

🔎 Initial Evaluation

Nasal Endoscopy Photos

Functional Issues

• 7x9mm septal perforation

• Severely damaged septal cartilage

• Chronic rhinitis

• Impaired nasal breathing

Aesthetic Concerns

• Visible cartilage through thin nasal tip skin

• Protrusive mouth profile

• Asymmetrical nostrils

Notable Factors

• Seven surgeries over 14 years

• Tissue damage due to inflammation

• Severely thinned nasal tip skin with fused cartilage grafts

• Correction limitations due to prior alar base reduction

✨ Patient Goals

The Desired Images of the Patient

• Improve facial harmony by softening mouth protrusion

• Achieve a more natural-looking nose

• Resolve functional breathing issues

• Ensure long-term surgical stability

## Patient’s Concerns and Surgical Plan

💉 Surgical Plan

Septal Reconstruction

• Full reconstruction of severely damaged septum using autologous rib cartilage

• Complete closure of 7x9mm septal perforation

Structural Rebuild

• Total nasal framework reconstruction with rib cartilage

• Removal of previously fused, malformed cartilage

• Dermal grafting to thicken compromised nasal tip skin

Aesthetic Enhancements

• Nasolabial angle correction to reduce protrusive appearance

• Improved columella–philtrum transition

• Harmonious nasal and facial lines

Functional Restoration

• Septoplasty to restore nasal airflow

• Turbinate reduction to treat chronic rhinitis

Limitations Management

• Discussed the inherent limitation in correcting nostril asymmetry due to previous alar base surgery

• Achieved maximal improvement within those constraints

## Before and After Photos

✅ Postoperative Results

Functional Recovery

• Full closure of septal perforation

• Significant improvement in breathing

• Marked relief from rhinitis symptoms

Before (Left) / Immediately After (Right)

Frontal View

• Naturally contoured nasal shape

• Improved facial balance

Before (Left) / Immediately After (Right)

Side View

• Softer mouth projection

• Refined nasolabial angle

• Smooth columella–philtrum transition

• Harmonious side profile

Before (Left) / Immediately After (Right)

Nostril Symmetry

• Visible improvement within realistic surgical limits

Rib Cartilage Nose Reconstruction: Before and After Video – Frontal and Side Views. This video shows the nasal shape improvements from both the front and side angles immediately after surgery.

Nasal Tip

• Resolution of visible cartilage problem

• Adequate restoration of skin thickness

• Naturally defined nasal tip contour

Long-Term Stability

• Durable structural integrity with autologous rib cartilage

• Minimal risk of revision surgery

## Final Results and Specialist’s Comments

👨‍⚕️ Expert Commentary

Immediately After Surgery: Frontal, Side, and Oblique Side View Photos

This was an extremely challenging case involving seven nasal surgeries across 14 years, resulting in both functional impairment and aesthetic concerns. The presence of a 7x9mm septal perforation, severely compromised septal cartilage, and visibly thinned nasal tip skin compounded the complexity.

The primary focus was closing the septal perforation. At this size, the defect significantly impacted breathing. The only viable approach was full septal reconstruction using autologous rib cartilage. Fortunately, the perforation was completely closed, and normal respiratory function was restored.

In the nasal tip, previous surgeries had left cartilage grafts fused together beneath thinning skin, causing visible protrusions and raising concerns about long-term skin integrity. We meticulously removed malformed tissue, reconstructed the framework using rib cartilage, and grafted dermis to restore skin thickness and prevent future complications.

To address the patient’s concern with her protrusive mouth appearance, we refined the nasolabial angle, creating a smoother and more natural connection between the nose and upper lip. While complete correction of nostril asymmetry was limited by previous alar base reduction, we achieved substantial improvement within the feasible range.

Ultimately, this case illustrates that even highly complex revision scenarios—marked by multiple surgeries, structural compromise, and long-term inflammation—can be resolved successfully through precise diagnosis, strategic planning, and the use of stable autologous grafts.

Thank you,Dr. Cha-Young KangMedical Director, Nose Lab Clinic

Important Notice: Possible Complications After Nasal Surgery