[Nose Lab Clinic]
Hello, this is Dr. Cha-Young Kang, Director of Nose Lab Clinic.
Today, I’d like to share the story of a patient who endured multiple revision surgeries due to ongoing dermal absorption, ultimately finding a lasting solution at our clinic. This case highlights how persistent issues from prior surgeries can be resolved with precision and expertise.
1. Surgical History
15 years ago: L-shaped silicone implant (caused contracture, pinched tip, and nasal redness).
14 years ago: Silicone with ear cartilage (to address thin nasal skin).
11 years ago: Silicone, autologous dermis, ear cartilage, and septal cartilage.
10 years ago: Silicone with donor rib cartilage.
8 years ago: Scalp fascia, postauricular dermis, and gluteal dermis.
2 years ago: Scalp fascia, postauricular dermis, and gluteal dermis.
15 years ago: Filler injection (removal planned during surgery).
The patient reported worsened left-sided nasal obstruction and aesthetic dissatisfaction due to ongoing changes in her nasal structure.
2. Patient Concerns
Design Consultation: Right Oblique Side View, Side View, and Nostril View Photos
Recurring dermal absorption leading to nasal deformity.
Significant nasal tip depression caused by repeated surgeries.
Frustration with the repeated need for revisions.
A desire for a natural and stable nasal contour.
Design Consultation: Right Oblique Side View, Side View, and Nostril View Photos
3. Patient Goals
A stable nasal structure free from dermal absorption issues.
A natural-looking tip without excessive projection.
Avoiding an overdone or “artificial” appearance.
Sufficient volume and structure for a balanced aesthetic.
Long-lasting results.
Improved nostril asymmetry and refined alar placement.
A rounded, non-pointed nasal tip.
1. Nose the Patient Likes 2. Nose the Patient Dislikes
4. Preoperative Analysis
a. Frontal View
Visible asymmetry from dermal absorption.
Pinched nasal tip due to contracture.
Deviated nasal bridge.
Excessive nostril visibility and asymmetry.
b. Side View
High radix (nasal starting point).
Over-rotated nasal tip with a large nasolabial angle.
Unnatural contour.
c. Nostril View
Severe asymmetry.
Deviated columella leaning rightward.
Scar tissue visible in the right nostril.
5. Surgical Plan & Execution
a. Structural Reconstruction
Complete reconstruction of the severely damaged nasal septum using autologous rib cartilage.
Restoration of the collapsed alar cartilages with precise grafting.
Nostril extension surgery for proper alignment and balance.
b. Volume Enhancement
Efficient reuse of existing autologous dermal tissue to minimize absorption risk.
Reinforcement around grafts for durability and support.
Overall volume enhancement to achieve a balanced profile.
c. Functional Improvement
Septoplasty and reconstruction for deviated septum.
Optimization of nasal airflow for improved breathing.
6. Surgical Outcomes
Before (Left) / Immediately After (Right)
a. Frontal View
Significantly reduced nostril visibility.
Corrected asymmetry with a smooth and natural bridge.
Proper alignment of the nasal tip and base.
Before (Left) / Immediately After (Right)
b. Side View
Lowered nasal starting point for a softer contour.
Tip depression corrected for a natural downward projection.
Improved nasolabial angle for a harmonious facial profile.
Before (Left) / Immediately After (Right)
c. Nostril View
Straightened columella.
Balanced nostril sizes with improved symmetry.
Refined nostril shape without visible scars.
Before (Left) / Immediately After (Right)
7. Expert Insights
Immediately After Surgery: Frontal, Side, and Oblique Side View Photos
Immediately After Surgery: Nostril View Photos
Recurrent dermal absorption and contracture from multiple revision surgeries present significant challenges in nasal reconstruction. This case required meticulous adherence to the following principles:
Complete removal of damaged and unstable tissue.
Reconstruction with stable and durable autologous materials.
Comprehensive correction of both functional and aesthetic issues.
By focusing on creating a robust structural foundation and minimizing future risks, we achieved a natural and stable result that meets the patient’s goals.
8. Closing Remarks
At Nose Lab Clinic, we are committed to listening carefully to each patient’s concerns and delivering long-lasting solutions tailored to their needs. For patients who have experienced ongoing issues with nasal surgery, we strive to restore confidence through expert care and precision.
This has been Dr. Cha-Young Kang, Director of Nose Lab Clinic.
Thank you!
