Revision Rhinoplasty for Short Nose and Columellar Depression Correction

noselab
2024년 10월 20일
3분 분량

최종 수정일: 6일 전

Revision Rhinoplasty for Short Nose and Columellar Depression Correction

Hello, this is Dr. Cha-Young Kang, head surgeon at Nose Lab Clinic.

Today, I would like to present a challenging revision rhinoplasty case involving a patient with a short nose and columellar depression due to severe inflammation. The surgery required reconstructing the nasal structure while carefully preserving the damaged skin.

Patient History and Pre-Surgery Consultation

The patient previously underwent:

July 2023: Rhinoplasty using Gore-Tex, septal cartilage, ear cartilage, and donor rib cartilage.
October 2023: Implant removal through nasal tip incision due to inflammation.

Patient’s Requests:

Autologous rib cartilage rhinoplasty for nasal bridge and tip
Correction of the short, upturned nose
Lowering columellar depression
Scar revision on nasal tip
Correction of nasolabial angle

Pre-Surgery Design Consultation: Frontal, Left Oblique, and Left Profile Views

Pre-Surgery Findings:

Broad, crooked nasal bridge with facial asymmetry
Short, upturned nasal tip with columellar depression
Severe nasal tip skin collapse due to inflammation
Nostril asymmetry and visible scarring

Pre-Surgery Design Consultation: Right Oblique, Right Profile, and Nostril Views

Surgical Plan and Key Techniques

To address the patient’s concerns, the following procedures were planned and executed using autologous rib cartilage:

Complete Septal Reconstruction – Full reconstruction with rib cartilage due to cartilage loss from prior inflammation.
Septal Extension Graft – To elongate and support the short, upturned nasal tip.
Lateral Osteotomy with Dorsal Augmentation – To straighten and refine the broad, crooked nasal bridge.
Removal of Remaining Gore-Tex – Ensuring no foreign material remained.
Alar Cartilage Reconstruction – Using rib cartilage to restore symmetry and nostril shape.
Correction of Nasal Tip Depression & Scar – Dermis and cartilage graft reinforcement with minimal skin damage.
Stem Cell Therapy – To aid in healing and improve skin regeneration.

Short nose and columellar depression correction – intraoperative photo after septal reconstruction and alar cartilage suturing during revision rhinoplasty — After septal reconstruction, the alar cartilages of the nasal tip were sutured

Before-and-After Results

Frontal View:

Columella naturally lowered for balance
Crooked nasal bridge corrected
Nasal tip depression and collapse significantly improved

Side profile view before surgery (left) after surgery (right)

Profile View:

Short nose elongated to proper proportions
Droopy, upturned tip corrected into a refined nasal line
Nasolabial angle balanced for natural harmony

Short nose and columellar depression correction – oblique 45-degree view before surgery (left) and after revision rhinoplasty (right) — 45-degree angle view before surgery (left) after surgery (right)

Oblique View:

Short and contracted nose corrected into a proportional and natural profile

Nostril View:

Nostril asymmetry corrected
Deep scar and collapse at nasal tip improved
Redness remains but expected to fade over time

Final Evaluation and Closing Remarks

Photos taken immediately after surgery, frontal view, 45-angle view, and side profile.

Short nose and columellar depression correction – nostril view immediately after revision rhinoplasty — Photo of the nostrils

This case highlights the complexity of short nose and columellar depression correction caused by severe inflammation. A key challenge was preserving the severely damaged nasal tip skin while ensuring structural stability with autologous rib cartilage.

The combination of septal reconstruction, alar cartilage repair, lateral osteotomy, and dermis/cartilage grafting achieved both functional restoration and natural aesthetics.

At Nose Lab Clinic, we emphasize careful preservation and advanced reconstructive techniques to achieve long-lasting, natural outcomes in even the most complex revision rhinoplasty cases.

For patients struggling with short nose or contracted nose due to skin and cartilage damage, consultation with an experienced rhinoplasty specialist is essential.

Thank you.

This has been Dr. Cha-Young Kang, head surgeon at Nose Lab Clinic.