[Nose Lab Clinic]
Hello, this is Dr. Cha-Young Kang, Director of Nose Lab Clinic.
Today, I’m sharing a challenging case of severe nasal inflammation caused by Medpor protrusion through the nasal mucosa. The condition was addressed with autologous rib cartilage reconstruction, achieving both functional and aesthetic improvements.
Design Consultation: Frontal View, Left Side View, and Oblique Side View Photos
1. Surgical History
Design Consultation: Right Side View, Oblique Side View, and Nostril View Photos
At 18 years old: Septal deviation correction + cartilage stitching
Subsequent revision: Persistent nasal deviation and drooping nasal tip
3 years later: Silicone removal, Alloderm augmentation
February 2023: Alloderm rhinoplasty revision
August 2023: Alloderm revision surgery
December 2024: Alloderm + silicone revision surgery
2. Patient’s Requests
Reference Images Desired by the Patient
3. Preoperative Examination Findings
Nasal Endoscopy: Medpor protrusion through the left nasal mucosa
These are nasal endoscopy photos.
CT Scan Findings:
Significant septal deviation
Inferior turbinate hypertrophy indicative of chronic rhinitis
4. Intraoperative Findings
Multiple fragments of Medpor embedded in the nasal tip
Photos of Removed Foreign Materials:
1.Medpor , 2.Medpor that Penetrated Through the Left Mucosa , 3.Silicone Implant from the Nasal Bridge
Acute inflammation surrounding the protruding Medpor
Severe damage to the septal cartilage from inflammation
Extensive loss of the left alar cartilage
Inflammatory changes surrounding Alloderm and silicone implants
5. Surgical Procedure
Before (Left) / Immediately After (Right)
Before (Left) / Immediately After (Right)
Before (Left) / Immediately After (Right)
Before (Left) / Immediately After (Right)
a. Treatment of Damaged Areas
Complete removal of Medpor fragments
Excision of inflamed tissues followed by thorough irrigation
Suturing of damaged nasal mucosa
Removal of contaminated Alloderm and silicone implants
b. Structural Reconstruction
Full septal reconstruction using autologous rib cartilage
Alar cartilage reconstruction and reinforcement
Correction of a dorsal hump through osteotomy
c. Aesthetic Refinement
Adjustment of a bulbous nasal tip using autologous rib cartilage
Smoothing of irregularities in the nasal dorsum for a straight-line profile
Nasolabial angle correction to reduce the appearance of a protruding upper lip
6. Surgical Outcomes
Immediately After Surgery: Frontal, Oblique Side, and Side View Photos
Immediately After Surgery: Nostril View Photos
a. Functional Improvements
Correction of septal deviation
Inferior turbinate reduction to address nasal obstruction
Complete removal of inflammatory tissue
b. Aesthetic Enhancements
Natural and smooth dorsal line
Balanced nasal tip with improved projection
Harmonious nasolabial angle
c. Structural Stability
Robust septal reconstruction
Rebuilt alar cartilage for stable nasal aperture
Significant improvement in breathing function anticipated
7. Expert Insights
Medpor protrusion causing nasal inflammation represents a highly complex surgical challenge. Key complications include:
Destruction of Surrounding Cartilage: Inflammation often leads to absorption or severe damage of adjacent cartilage structures.
Delayed Diagnosis: Medpor protrusion is often identified late due to its internal progression, worsening the prognosis.
Persistent Inflammation: Chronic inflammation is difficult to manage and complicates surgical planning.
These cases highlight the importance of:
Safe Material Selection: Choosing biocompatible materials reduces risks of inflammation and long-term complications.
Surgical Precision: Ensuring proper placement and fixation of implants is crucial to avoiding complications.
Proactive Management: Early removal of problematic materials such as Medpor is essential to prevent irreversible damage.
I hope this case offers valuable insights into the complexities and solutions in challenging nasal reconstructive surgeries.
Dr. Cha-Young Kang
Director, Nose Lab Clinic
Thank you.
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