Revision Rhinoplasty with Rib Cartilage: Correcting an Over-Rotated and Pinched Nose

Hello, this is Dr. Cha-Young Kang, Director of Nose Lab Clinic, a rhinoplasty specialist clinic in Seoul, Korea.

Today, I’d like to introduce a challenging case of revision rhinoplasty with rib cartilage performed to correct an over-rotated and pinched nose after multiple previous surgeries.

This case emphasizes the importance of comprehensive structural reconstruction to achieve both long-term stability and natural results.

Before Surgery: Frontal, Right Side, and Oblique Side View Photos

1. Patient Background and Desired Outcomes

Surgical History

• 1991: Initial rhinoplasty with silicone

• 2020: Augmentation with silicone and donated rib cartilage

• 2021: Revision for height adjustment

• 2022: Philtrum reduction surgery

Patient’s Requests

• Correction of over-rotated, pinched nose

• Natural but refined straight nasal line

2. Preoperative Analysis

Before Surgery: Nostril View, Left Side View, and Oblique Side View Photos

Frontal View:

• Upturned nasal tip (over-rotation)

• Pinched nostril/alar appearance

• Crooked nasal bridge

• Nostril asymmetry

Profile View:

• Drooping nasal tip

• Hump on the bridge

• Nose appears short

Nasal Base View:

• Asymmetrical nostrils

• Deviated columella to the left

• Severe pinching of alar cartilage

3. Surgical Plan for Revision Rhinoplasty with Rib Cartilage

• Crooked Nose Correction: Lateral osteotomy for straightening

• Structural Reinforcement: Autologous rib cartilage graft for septal reconstruction

• Alar Cartilage Repair: Dermal grafts to correct pinched nostrils

• Tip & Length Restoration: Septal extension graft for improved length and projection

• Nostril Symmetry: Adjust alar base and length with grafts

• Augmentation for Defined Line: Replace silicone implant for smooth, refined bridge

• Nasolabial Angle Improvement: Better facial balance

• Additional Harmonization: Fat grafting to forehead for softer contour

4. Surgical Approach

Septal Reconstruction with Rib Cartilage

• Autologous rib cartilage was used to rebuild the damaged septum, establishing a strong foundation for nasal support.

Alar Cartilage Reconstruction

• Severely damaged alar cartilages were reconstructed and reinforced with dermal grafts to resolve the pinched appearance.

Additional Procedures

• Midface augmentation to restore balance

• Removal of foreign forehead material followed by fat grafting

5. Postoperative Results

Before (Left) / Immediately After (Right)

Frontal View:

• Natural correction of overly rotated, pinched areas

• Straightened nasal bridge with improved alignment

• Enhanced nostril symmetry

Before (Left) / Immediately After (Right)

Profile View:

• Smooth, straight bridge after hump correction

• Drooping nasal tip elevated for balance

• Improved nasolabial angle for harmony

Before (Left) / Immediately After (Right)

Nasal Base View:

• Noticeable improvement in nostril symmetry

• Natural, smooth curvature of alar rims

Before (Left) / Immediately After (Right)

6. Conclusion

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

Immediately After Surgery: Nostril View Photos

This revision rhinoplasty with rib cartilage successfully restored a nose that had been altered by multiple surgeries, achieving a natural, stable, and refined result.The focus was not only on aesthetics but also on rebuilding the nasal framework for long-term stability.

Complex revision rhinoplasty requires meticulous anatomical understanding and advanced surgical expertise. At Nose Lab Clinic, we place equal value on both the beauty and the functional health of the nose.

Thank you for reading.

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

Nose Lab performs all surgeries using a closed (endonasal) approach.

Messenger(WhatsApp) : +82 1057360302

Home page : www.noselab.co.kr

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Email : noselab@naver.com