[Nose Lab Clinic]

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

Today, I’d like to share a challenging case involving a 17-year-old Gore-Tex nasal implant that led to contracture, severe nasal asymmetry, septal perforation, and chronic rhinitis. Through a complex reconstructive surgery utilizing autologous rib cartilage, we successfully restored both nasal function and aesthetics.

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

Design Consultation: Right Side View, Oblique Side View, and Nostril View Photos

1. Surgical History

🔹 17 years ago: Gore-Tex nasal implant (bridge + tip) + Alar Base Reduction

🔹 3-5 years ago: Septal perforation repair attempt + Non-implant revision

Reference Images Desired by the Patient

2. Initial Diagnosis & Key Issues

🔍 Persistent septal perforation

Nasal Endoscopy Image: Septal Perforation (+)

🔍 Severe loss of septal cartilage

🔍 Significant nasal asymmetry due to contracture

🔍 Restricted nasal skin elasticity

🔍 Chronic rhinitis symptoms

3. Surgical Goals

✅ Complete closure of the septal perforation

✅ Reconstruct missing septal cartilage

✅ Restore nasal symmetry & reduce contracture effects

✅ Improve nasal airflow & alleviate chronic rhinitis

4. Intraoperative Findings & Surgical Plan

a. Key Findings During Surgery

• Septal perforation was significantly larger than anticipated.

• Severe depletion of septal cartilage—remaining structure was insufficient for support.

• Extensive scar tissue and contracture, restricting nasal mobility.

• Thinned nasal mucosa due to prolonged implant-related stress.

b. Reconstruction Procedure

• Performed septal perforation closure using autologous mucosal grafting.

• Rebuilt missing septal cartilage with autologous rib cartilage grafting.

• Eliminated scar tissue & contracture while preserving as much native tissue as possible.

• Refined nostril asymmetry & restructured alar base for natural symmetry.

c. Functional Enhancements

• Treated chronic rhinitis through submucosal turbinate reduction.

• Stabilized nasal framework for long-term functional and aesthetic balance.

5. Post-Surgery Outcomes

Before (Left) / Immediately After (Right)

a. Functional Improvements

✔ Successful closure of septal perforation

✔ Reinforced and reconstructed nasal septum

✔ Significantly improved nasal airflow

Before (Left) / Immediately After (Right)

b. Aesthetic Refinements

✔ Correction of contracture-related deformities

✔ Natural, well-balanced nasal contour

✔ Harmonized nostril symmetry

Before (Left) / Immediately After (Right)

c. Overall Transformations

✔ Restored nasal structural integrity

✔ Simultaneously achieved functional & cosmetic enhancements

✔ Long-lasting, natural results

Before (Left) / Immediately After (Right)

6. Expert Insights

This case presented multiple complex challenges, primarily due to long-term implant-induced contracture and significant septal damage.

Key Takeaways:

🔹 Long-term Gore-Tex implants can lead to severe soft tissue contraction and cartilage absorption, requiring extensive reconstructive surgery.

🔹 Septal perforation repair is highly intricate and demands precise grafting techniques to prevent future complications.

🔹 Autologous rib cartilage is the most reliable material for long-term structural stability in such cases.

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

Immediately After Surgery: Nostril View Photos

At Nose Lab Clinic, we specialize in complex revision rhinoplasty cases that require both functional restoration and aesthetic refinement.

Dr. Cha-Young Kang

Director, Nose Lab Clinic

Thank you.