Hello, this is Dr. Chayoung Kang, Director of Noselab Rhinoplasty Clinic. Today we will introduce a case of severe nasal contracture and an upturned nose.
This is the case of a patient who underwent an autologous costal cartilage rhinoplasty at another hospital. However, only 3 days post-operation, she developed inflammation, which required a general removal surgery, in spite of which she ultimately developed a severe nasal contracture deformity.
Rhinoplasty reconstruction surgery plans often vary significantly depending on the patient’s condition during the surgery. This patient’s skin had barely stretched, so the goal of this surgery was to stretch the nasal skin as much as possible. We planned to perform a second surgery to increase the volume and height of the nose, as well to reinforce the nasal bridge once the skin had stabilized and stretched sufficiently in approximately 6 months later.
Preoperative Design Consultation
Frontal view
Excessively visible nostrils due to the upturned appearance of the nose tip.
The right nostril is more prominent and slanted.
Plain and crooked nose bridge.
Pinched appearance of both nostrils.
Lateral view
Wide nasolabial angle (between the lips and nose tip)
Upturned and short nose.
Plain nasal bridge.
Long philtrum.
45-degree angle view
The upturned and crooked nose is more prominent.
The appearance of the nasal bridge looks more plain.
Nostril photo
Prominent nostril asymmetry
Distinctive nostril roundness and lifting
Surgical contents
a) Autologous rib cartilage harvesting
Suficient reinforcement of the cartilage on both sides required for the nasal reconstruction with the harvested costal cartilage.
b) Septal cartilage reconstruction
Reconstruction of the damaged septal cartilage using the autologous cartilage.
This provides a foundation that reinforces the structure of the nose and corrects the upturned nose.
c) Reconstruction of the alar cartillage
Reconstruction the crushed and asymmetric alar cartilage using the rib cartilage.
This will improve the symmetry of the nostrils.
d) Raising the nose bridge
Increasing the height of the nose bridge that looked plain.
Straightening the deviated nose bridge to improve the overall nose shape.
e) Stretching the skin on the nasal dorsum:
Performed a surgery to stretch the skin that had become tight due to the nasal contracture as much as possible.
This played an important role at improving the overall lenght of the nose.
Every procedure was performed through the closed rhinoplasty approach, without leaving any external scars.
Before and After surgery photos
The severely upturned nose tip became more natural and it was lowered to reduce the exposure of the nostrils.
Improvement of the asymmetry produced due to the slant towards the right side.
Transformed the the plain bridge into a straight and three-dimensional nose bridge.
Improvement of the natural shape of both nostrils that previously appeared to be pinched.
Adjustment and reduction of the excessively wide nasolabial angle, making the harmony between the lips and the nose improve.
The overall balance of the nose improved as the nose became enlongated.
The plain nose bridge became more three-dimensional.
The lenght of the philtrum also improved.
The nose shape became smoother compared to the previously deviated and upturned nose.
The three-dimensionality of the nose bridge improved the balance of the whole face.
The severe asymmetry improved greatly.
By correcting the crushed and lifted appearance of the right nostril, the asymmetry has improved,
After surgery table photos
Overview – Severe Nasal Contracture
This case is a good example of the complexity and difficulty of correcting severely contracted nose due to inflammation. Especially when the nose is originally small and short, it is very difficult to restore the nose to its original size after it has become even smaller and shorter due to contracture.
In this patient’s case, the tip of the nose became shorter due to contracture of the skin of the nasal dorsum just above the tip of the nose. In this situation, stretching the skin of the nose was a particularly difficult task. In addition, since a severely upturned nose tip usually means severe damage to the septal cartilage, so the main goal of this surgery was to reconstruct the damaged cartilage and stretch the shortened skin as much as possible.
Using only autologous costal cartilage to reconstruct the septum cartilage, alar cartilage, and bridge of the nose was the best choice to achieve long-term, stable results. Using autologous tissue minimized the risk of rejection and secured a sufficient amount of cartilage, making this complex reconstructive surgery possible.
I hope this blog post gives hope to those who are struggling due to nasal contracture. Correcting nasal contracture is a complex and difficult surgery, but it is possible to obtain satisfactory reuslts through the correct techniques and surgical plan.
Noselab Rhinoplasty Clinic always provides the most optimized surgical plan for each patient based on the latest medical technology and abundant experience. Those who are considering rhinoplasty should consult with a specialist to find the method that is best for them.
With Noselab Clinic you can achieve a beautiful and healthy nose!
Thank you
Noselab Rhinoplasty Clinic
Dr. Chayoung Kang.
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