Revision Rhinoplasty for Nasal Contracture and Obstruction: Overcoming 15 Years and 8 Surgeries

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A 15-Year Journey to Resolve Nasal Contracture and Obstruction

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

Today, I’d like to share the story of a remarkable patient who endured 15 years and eight rhinoplasty procedures before finding a resolution to persistent nasal contracture and obstruction. This case illustrates the importance of a tailored, systematic approach to revision rhinoplasty for nasal contracture and obstruction.

– 15-year, 8-surgery history case at Nose Lab Clinic. — Design Consultation: Frontal View, Left Side View, and Oblique Side View Photos

1. Surgical History

A Timeline of Multiple Surgeries and Complications

15 years ago: Gore-Tex + ear cartilage (overly natural appearance led to revision).
14 years ago: L-shaped silicone + ear cartilage (contracture and upturned nasal tip).
12 years ago: Autologous rib cartilage + dermal fat graft from buttocks (nose at risk of collapse).
11 years ago: Rib cartilage + septal cartilage, no implant (wide nasal dorsum).
10 years ago: AlloDerm (allergic reaction).
9 years ago: AlloDerm removal + additional rib cartilage.
2 years ago: Existing materials reused + dermal graft + ear cartilage.
1 year ago: Fat grafting followed by monthly dermal injections (7–8 sessions).

A major turning point came with the allergic reaction to AlloDerm during the fifth surgery and severe septal cartilage damage over time.

Right side, oblique side, and nostril view before revision rhinoplasty for severe nasal contracture and obstruction – 15-year, 8-surgery history case at Nose Lab Clinic. — Design Consultation: Right Side View, Oblique Side View, and Nostril View Photos

2. Key Challenges in Revision Rhinoplasty for Nasal Contracture and Obstruction

Severe septal cartilage damage
Upturned nasal tip
Bilateral alar pinching
Irregular nasal tip cartilage
Asymmetric nostrils
Severe nasal obstruction
Dorsal depression

3. Surgical Plan

a. Structural Reconstruction

Complete septal reconstruction using autologous rib cartilage
Correction of upturned nasal tip
Alar cartilage reconstruction

b. Soft Tissue Refinement

Dermal grafts to restore alar shape
Correction of nasal tip irregularities
Scar tissue removal

c. Functional Improvement

Septal reconstruction to restore external nasal valve function.
Correction of nostril asymmetry.
Resolution of nasal obstruction.

d. Dorsal Augmentation

Removal of scar tissue.
Creation of a smooth and straight nasal dorsum.

4. Surgical Outcomes

Side view before (left) and immediately after (right) revision rhinoplasty for severe nasal contracture and obstruction – showing improved nasal tip position and smoother dorsum. — Before (Left) / Immediately After (Right)

a. Structural Improvements

Stable septal reconstruction for long-term support
Natural nasal tip positioning
Symmetrical alar contour restoration

Frontal view before (left) and immediately after (right) revision rhinoplasty for severe nasal contracture – improved nasal symmetry and reduced dorsal irregularities. — Before (Left) / Immediately After (Right)

b. Functional Recovery

Complete resolution of nasal obstruction
Widened nasal airway
Improved breathing function

Oblique side view before (left) and immediately after (right) revision rhinoplasty for severe nasal contracture – restored nasal tip projection and smoother dorsal line. — Before (Left) / Immediately After (Right)

c. Aesthetic Enhancements

Smooth, symmetrical nasal dorsum
Natural-looking nasal tip
Corrected nostril asymmetry

Nostril view before (left) and immediately after (right) revision rhinoplasty for severe nasal contracture – corrected nostril asymmetry and improved columella support. — Before (Left) / Immediately After (Right)

5. Expert Insights on Complex Revision Rhinoplasty

This case required a precise understanding of the multiple complications arising from repeated surgeries. Critical principles included:

Accurate diagnosis and personalized planning
Comprehensive septal reconstruction as the foundation of both aesthetics and function
Meticulous scar tissue management and dermal grafting for a natural outcome

Immediately after revision rhinoplasty for severe nasal contracture – frontal, oblique side, and right side views showing improved nasal contour and columella support. — Immediately After Surgery: Frontal, Oblique Side, and Side View Photos

Immediately after revision rhinoplasty – nostril view showing corrected asymmetry and improved nasal base shape. — Immediately After Surgery: Nostril View Photos

6. Closing Thoughts

This patient’s journey highlights the challenges and possibilities in revision rhinoplasty for nasal contracture and obstruction. With the right expertise, even the most complex cases can achieve both functional recovery and aesthetic improvement.

At Nose Lab Clinic, we are dedicated to delivering personalized, high-quality care for patients facing similar challenges. All surgeries at Nose Lab Clinic are performed using the closed rhinoplasty technique.