Natural, Implant-Free Nasal Reconstruction Using Rib Cartilage – Real Patient Story

[Nose Lab Clinic]

Hello, this is Dr. Cha-Young Kang, Director of Nose Lab Clinic.

Today, I’d like to share the case of a patient who experienced nostril asymmetry and tip drooping following multiple nasal surgeries. She wished to avoid silicone implants, so we reconstructed her nose using only autologous rib cartilage, achieving a natural, refined result without implants.

Design Consultation: Frontal View, Left Side View, and Oblique Side View Photos

📍 Surgical History

• 15 years ago: Silicone + septal cartilage + ear cartilage rhinoplasty

• 10 years ago: Revision surgery using donated rib cartilage, implant-free

🔎 Initial Assessment

1. Frontal View

• Nostril asymmetry

• Excessive nostril show

• Wide nasal base

Design Consultation: Right Side View, Oblique Side View, and Nostril View Photos

2. Side Profile

• Appropriately lowered columella

• Smooth, straight dorsal line

• Lifted, well-defined nasal tip

• Harmonized nasolabial angle

3. Additional Findings

• Scar on the right columella

• Deviated septum (toward the left)

• Weakened septal cartilage from prior surgery

• Left-sided nasal obstruction

Nasal Endoscopy Photos

✨ Patient Goals

• Improve nostril asymmetry

• Reduce nostril show

• Lower the columella, refine the nasolabial angle

• Achieve natural results without silicone

The Desired Images of the Patient

💉 Surgical Approach

1. Structural Reinforcement

• Identified severely weakened septum from over-harvested cartilage in past surgery

• Used autologous rib cartilage to rebuild and reinforce the septum

• Corrected the leftward septal deviation

2. Aesthetic Refinement

• Lateral osteotomy to narrow the wide nasal bones

• Used rib cartilage to form a natural dorsal line (implant-free)

• Lowered the columella for better balance

3. Fine-Tuning

• Crushed cartilage and dermal graft to smooth irregularities on the nasal bridge

• Refined nasolabial angle

• Improved the scar and asymmetry on the right columella

✅ Postoperative Outcome

Before (Left) / Immediately After (Right)

1. Frontal View

• Balanced nostrils

• Reduced nostril show

• Slimmed, more elegant nasal contour

• Straighter nasal line

Before (Left) / Immediately After (Right)

2. Side Profile

• Appropriately lowered columella

• Smooth, straight dorsal line

• Lifted, well-defined nasal tip

• Harmonized nasolabial angle

Before (Left) / Immediately After (Right)

3. Function

• Strong, reinforced septal structure

• Improved nasal airflow, especially on the left side

Before (Left) / Immediately After (Right)

👨‍⚕️ Expert Commentary

Immediately After Surgery: Frontal, Side, and Oblique Side View Photos

Immediately After Surgery: Nostril View Photos

This case involved a complex revision following multiple surgeries, including over-harvesting of septal cartilage. The weakened internal structure caused visible asymmetry and tip drooping. We addressed this by reinforcing the septum using autologous rib cartilage, and carefully reshaped the nose without the use of silicone.

The dorsal contour was smoothed with crushed cartilage and dermis, and nostril asymmetry was corrected through precise adjustments to the columella and alar base. As requested, the entire procedure was completed without implants, and the outcome is both natural and structurally sound.

This case highlights the power of implant-free rhinoplasty when performed with a tailored, anatomical approach and experienced surgical technique.

This has been Dr. Cha-Young Kang, Director of Nose Lab Clinic.

Thank you.