[Nose Lab Clinic]
Hello, this is Dr. Cha-Young Kang from Nose Lab Clinic.
Today, I’d like to introduce a case involving nasal tip and bridge transparency that developed after an L-shaped silicone rhinoplasty 18 years ago. The patient experienced skin thinning and material translucency, creating a harsh appearance and an unnatural contour. This case required structural reinforcement using autologous rib cartilage and dermal grafts to restore a natural and stable nasal shape.
Design Consultation: Frontal View, Left Side View, and Oblique Side View Photos
1. Patient’s Previous Procedures & Concerns
Surgical History
19 years ago: Filler injection
18 years ago: L-shaped silicone + ear cartilage graft + filler removal
6 months later: Aloderm graft to address cartilage translucency
Initial Evaluation
Cartilage translucency at the nasal tip
Silicone translucency along the nasal bridge (chalky appearance)
Skin thinning, causing structural instability
Harsh and rigid facial expression
2. Patient’s Goals
Eliminate nasal tip translucency
Address the chalky appearance of the silicone implant
Achieve a soft and natural contour
Enhance overall facial harmony with a gentler expression
Design Consultation: Right Side View, Oblique Side View, and Nostril View Photos
3. Surgical Plan & Execution
a. Skin Tension Adjustment
Slightly lowered the nasal tip to relieve excessive skin tension
Reduced overall tension on the thin nasal skin
Reinforced the thinned skin with a dermal graft
b. Nasal Tip Structural Enhancement
Used autologous rib cartilage to build a durable tip framework
Increased the surface area of cartilage contact to prevent translucency
Ensured long-term stability by reinforcing structural integrity
c. Nasal Bridge Refinement
Removed Silicone Implant
Replaced previous implant with a wider, softer prosthesis
Eliminated the chalky, translucent effect
Added autologous tissue grafts to strengthen the skin
4. Post-Surgical Results
Before (Left) / Immediately After (Right)
a. Nasal Tip
✔ Translucency resolved
✔ Harmonious width and projection
✔ Enhanced structural stability
Before (Left) / Immediately After (Right)
b. Nasal Bridge
✔ Eliminated chalky translucency
✔ Smoother, more refined contour
✔ Natural-looking height and proportions
Before (Left) / Immediately After (Right)
c. Overall Facial Aesthetic
✔ Softer, more balanced appearance
✔ Natural transition between nasal tip and bridge
✔ Well-proportioned nasal structure
Before (Left) / Immediately After (Right)
5. Expert Insights
Immediately After Surgery: Frontal, Side, and Oblique Side View Photos
Immediately After Surgery: Nostril View Photos
This case demonstrates how prolonged use of L-shaped silicone implants can lead to skin thinning and material translucency over time. Two primary factors contribute to these issues:
Skin thinning due to long-term implant pressure, making underlying materials visible.
Implant properties, such as being too rigid, narrow, or overly elevated, which can exacerbate translucency.
To effectively address these problems, I implemented a multi-layered approach:
Lowering the nasal tip to reduce skin tension
Reinforcing the skin with dermal grafts
Expanding cartilage coverage to diffuse light reflection and prevent future translucency
Using a broader, softer bridge implant to enhance smoothness and reduce the chalky effect
By utilizing autologous rib cartilage for long-term stability, we were able to create a natural, well-proportioned nasal shape that is both aesthetically refined and structurally resilient.
This is Dr. Cha-Young Kang, Chief Surgeon at Nose Lab Clinic.
Thank you.
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