Revision Rhinoplasty – Refining the Nose 10 Years After Primary Surgery

Revision Rhinoplasty – Refining the Nose 10 Years After Primary Surgery

Hello, I’m Dr. Cha-Young Kang from NoseLab Clinic.

Today, I’d like to introduce a case where a patient resolved long-standing discomfort and achieved her ideal nose profile—ten years after her first surgery. This was a challenging revision rhinoplasty case requiring structural reconstruction and aesthetic refinement.

Revision Rhinoplasty – Patient History and Clinical Analysis

Surgical & Medical Background:

• 10 years ago: Primary rhinoplasty with silicone, septal cartilage, and ear cartilage

• 5 years ago: Sinus surgery at a local ENT clinic

Preoperative design consultation photos: Frontal view, left oblique side view, and left side view.

Main Complaints:

• Severe nasal obstruction (left side)

• Upturned tip with excessive nostril show

• Uneven, bumpy dorsal line

• Unnatural profile and facial imbalance

Preoperative design consultation photos: Right side view, right oblique side view, and nostril view.

Clinical Findings:

• Naturally small and short nose

• Severely deviated septum bent to the left

• Excessive nostril exposure in frontal view

• Depressed mid-bridge with height only at the root

Diagnosis:

The main issue was over-harvesting of septal cartilage during the first surgery, which caused:

• Collapsed and deviated septum

• Weak internal support

• Long-term breathing difficulty and deformity

Surgical Plan for Revision Rhinoplasty – Restoring Structure and Balance

1. Septal Reconstruction

• Rebuilt the septum using autologous rib cartilage

• Restored nasal framework stability

• Improved airflow and resolved obstruction

2. Nasal Tip Extension

• Extended short tip within skin safety limits

• Lowered the upturned tip

• Achieved a natural nasolabial angle

3. Dorsal Line Correction

• Filled depressed bridge areas

• Smoothed bumpy contour

• Created a straight, refined dorsal line

4. Columella & Angle Refinement

• Adjusted columella shape

• Balanced the nasolabial angle

• Enhanced facial harmony

Outcomes and Key Lessons from Revision Rhinoplasty

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

Functional Results:

• Nasal obstruction fully resolved

• Restored symmetry between both nasal passages

• Comfortable, stable breathing

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

Aesthetic Enhancements:

• Minimized nostril exposure

• Straightened and smoothed nasal bridge

• Achieved natural, proportionate tip angle

• Restored facial balance

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

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

⚠️ Key Lesson – The Risks of Over-Harvesting Cartilage

This case highlights how aggressive cartilage removal in primary surgery can lead to structural collapse, functional problems, and aesthetic deformity years later.

Revision Rhinoplasty Principles:

1. Accurate diagnosis with CT and clinical review

2. Durable reconstruction with autologous rib cartilage

3. Realistic goals respecting skin elasticity

Surgeon’s Final Thoughts

Preoperative Video / Immediate Postoperative Video

Helping this patient regain both confidence and comfort after more than a decade was deeply rewarding. Revision rhinoplasty requires greater caution and precision than primary surgery, but with careful planning, it can restore both function and beauty.

This post is based on a real patient case. Outcomes may vary depending on individual anatomy and condition.

— Dr. Cha-Young Kang, NoseLab Clinic

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