Hello, this is Dr. Cha-Young Kang, director of Nose Lab Clinic.
Today, I’m sharing a case involving a patient whose previous surgeries using donor rib cartilage resulted in absorption and deformation of the nasal structure. The comprehensive approach taken here highlights the critical role of structural stability and aesthetic harmony in revision rhinoplasty.
1. Surgical History
2005: Silicone implant, Alloderm, septal cartilage
2017: Silicone implant, donor rib cartilage
2017: Alar base reduction
2018 (July): Silicone replacement with additional correction
2. Key Symptoms and Patient Requests
Functional issues: Severe rhinitis, difficulty breathing
Aesthetic preferences: Glamorous and refined appearance
3. Preoperative Analysis
Design Consultation: Frontal View, Left Side View, and Oblique Side View Photos
a. Frontal View
Crooked nose
Pinched appearance of the nostrils
b. Side View
Overly elongated nose
Drooping nasal tip
Protruding mouth appearance
High starting point of the nasal bridge
Design Consultation: Nostril View, Right Side View, and Oblique Side View Photos
c. Nostril View
Asymmetric nostrils
Tilted columella to the left
A functional evaluation also revealed septal deviation and hypertrophic rhinitis, requiring structural and functional correction.
4. Surgical Approach
a. Replacement of Donor Rib Cartilage
Removed partially absorbed donor cartilage.
Replaced with autologous rib cartilage, ensuring durability and stability.
b. Septal Reconstruction
Corrected deviated septum.
Utilized autologous rib cartilage for reconstruction and septal extension.
c. Nasal Tip Refinement
Created a defined and elevated nasal tip.
Adjusted columella to achieve natural downward projection.
Corrected nasolabial angle for balance.
d. Bridge Adjustment
Lowered the high starting point of the nasal bridge.
Improved overall proportionality and reduced excessive length.
5. Results
a. Frontal View
Before (Left) / Immediately After (Right)
Straightened nose with improved symmetry.
Restored natural width and corrected pinched nostrils.
b. Side View
Before (Left) / Immediately After (Right)
Lowered starting point for a softer profile.
Achieved appropriate nasal length and projection.
Enhanced nasolabial angle, improving the appearance of protruding mouth.
c. Three-Quarter View
Before (Left) / Immediately After (Right)
Improved natural contour of the bridge.
Enhanced tip definition for a balanced aesthetic.
Reduced prominence of protruding mouth, achieving a cohesive look.
d. Nostril View
Before (Left) / Immediately After (Right)
Symmetrical nostrils with balanced width.
Straightened columella for a centered alignment.
Corrected pinched nostrils for a smoother look.
6. Specialist Insights
The critical focus of this case was replacing the unstable donor rib cartilage with robust autologous rib cartilage. This substitution not only stabilized the nasal structure but also provided the foundation for natural-looking refinement.
By simultaneously addressing functional issues such as nasal obstruction and correcting aesthetic imbalances, we achieved a high level of patient satisfaction. The results reflect a harmonious blend of functionality and aesthetics, aligning with the patient’s desire for a glamorous yet natural appearance.
Immediately After Surgery: Frontal, Side, and Oblique Side View Photos
Immediately After Surgery: Nostril View Photos
Closing Remarks
Revision rhinoplasty cases involving absorbed donor materials require meticulous planning and execution. This case demonstrates the transformative potential of autologous cartilage for restoring both structure and aesthetics.
For those struggling with similar challenges, seeking a tailored solution from an experienced specialist is essential. At Nose Lab Clinic, we are dedicated to providing personalized care that delivers optimal outcomes.
Thank you for reading. This is Dr. Cha-Young Kang from Nose Lab Clinic.
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