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Severe Contracted Nose Reconstruction: A High-Complexity Case Study_Rhinoplasty Korea

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Hello, I’m Dr. Cha-Young Kang, Director of Nose Lab Clinic.


Today, I’m sharing a highly challenging case of contracted nose reconstruction that involved overcoming multiple complications to achieve a successful outcome. This case underscores the importance of meticulous planning and advanced techniques in complex nasal reconstructive surgery.


1. Patient Condition

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

  • Initial Complications: After a nasal reconstructive surgery, the patient underwent a facelift, which led to hematoma formation on both sides of the face, causing graft necrosis in the nasal area.

  • Structural Issues: Severe columella retraction, a short and upturned nasal tip, leftward deviation, and significant contraction.

  • Mucosal Compromise: The left-sided mucosal septum had thinned and contracted following graft necrosis in the previous reconstructive attempt.


2. Surgical Plan


To address these complex issues, we created a comprehensive surgical plan involving the following steps:

  • Stem Cell Injection Therapy: To promote healing and tissue repair.

  • Septal Reconstruction with Autologous Rib Cartilage: For structural reinforcement and stabilization.

  • Nasal Bridge Correction with Autologous Cartilage: Replacing the previous silicone implant to avoid further inflammation or rejection, while lowering the bridge starting point.

  • Rotational Flap Graft of Inferior Turbinate Mucosa: To reinforce the left-side mucosal septum.


3. Pre-Surgical Assessment


Key Observations:

  • Severe columella retraction

  • Significant leftward nasal tip deviation

  • Shortened and upturned nasal tip

  • High radix (nasal bridge starting point) contributing to a harsh profile

  • Nostril asymmetry and leftward deviation of the columella


4. Surgical Outcomes


The surgery was successfully completed, with the following results:

  • Columella Correction: Significant improvement in the position of the columella.

  • Lowered Nasal Tip and Bridge Start Point: A more natural and aesthetically pleasing profile.

  • Symmetry Improvement: Notable correction of nostril asymmetry and columella deviation.

  • Effective Contracture Release: Achieved through careful cartilage grafting and mucosal flap techniques.

Before (Left) / Immediately After (Right)

Before (Left) / Immediately After (Right)

Before (Left) / Immediately After (Right)

Before (Left) / Immediately After (Right)


Closing Remarks


This was an exceptionally complex case, but each aspect of the surgical plan was executed successfully, leading to a positive outcome. Contracted nose reconstruction is a high-difficulty procedure that often requires multiple stages. In severe cases like this, a second-stage surgery may be needed after six months to further refine the aesthetic result.


This case demonstrates the effectiveness of combining stem cell therapy with autologous tissue grafting, even in cases with extensive scarring or contraction. Achieving a successful outcome in complex reconstructive cases hinges on a step-by-step approach and long-term treatment planning.


For anyone considering nasal reconstruction, consultation with an experienced specialist is essential. At Nose Lab Clinic, we are committed to providing optimal, personalized care for each patient, and we approach complex reconstructions with a focus on both functionality and aesthetics.


Thank you,


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



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