Hello, this is Dr. Chayoung Kang, Director of Noselab Clinic. Today we will introduce the case of a patient that presented nasal collapse caused by damaged cartilage. This patient wanted to correct an upturned nose and overall improve his nose shape.
Preoperative Design Consultation
The patient came to the clinic to solve the following issues:
Nasal congestion on the left side.
Droopy nose.
Nose deviated to the right side.
High glabella starting point.
Nostril asymmetry observed when seen from the front.
Retracted columella caused by the small nasolabial angle and protruding mouth.
The patient;s requirements were as follows:
Increase the overall height of the nose.
Correct the upturned nose.
Correct the wide nose.
Pull the alar up if possible
It is important to note that since this patient had already undergone 2 previous rhinoplasty surgeries, this was a great limiting factor durin the surgical planning.
Surgical content
The surgery was complicated as it took 2 hours longer than it had been planned.
a) Alar peeling: The alar cartilage in both sides was already in a basically non-existent condition.
b) Confirming the state of the septal cartilage: Only some part of the cartilage near the nasal dorsum, and the columella remaid, and it was overall gone. The support structure of the nose tip was weak. Nasal congestion had developed due to the nasal cavity narrowing on the left side after the previous surgery, in which there was cartilage added to the septum on the left side.
c) Reconstructive surgery: Complete reconstruction of the septal and alar cartilage using the self-rib cartilage. Removal of the contractured tissue on the nose bridge and stretch the skin as much as possible. Improving the nostrils by completely reconstructing the alar cartilage with the autologous costal cartilage.
d) Additional corrections: Alar base reduction surgery and ascending the alar. Nasolabial angle correction. Improving the height of the nose by stretching the skin as much as possible.
Before and After Surgery Photos
The nasolabial angle was definitely corrected.
The nose tip height was increased to be more than the height of the forehead.
The droopy nose tip was improved.
The nose tip became more prominent.
The deviated parts improved.
The thin nose tip and the visible nostrils issue were imporved.
The elevation of the alar is noticeable.
The tilted columella was moved to be straight.
The narrow parts inside the left nasal cavity were improved.
The nostril asymmetry improved greatly.
The nasal base was reduced significantly.
After Surgery Table Photos
Overview
There are many cases like this one in revision patients. Many times the actual condition of the patient is worse than expected, however, it is hard to explain it in detail unfortunately. In the case of a revision surgery, it is more important to what hospital to go and the surgical method rather than the number of surgeries performed. The number of surgeries may be the same but the results may vary.
Needing revision surgery or not, the duration, results, and prognosis may have considerable differences, Also, the surgical plan may be different, so it is important to receive exact information related to the surgery during the preoperative consultation.
This case was of a patient that had a surgery that lasted 2 hours longer than what it was originally planned. However, through the reconstructive surgery we were able to obtain satisfactory results
I hope this blog is of help to people who are concerned due to damaged septal cartilage, or nasal deformation.
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