[Nose Lab Clinic]
Hello, this is Dr. Cha-Young Kang, Director of Nose Lab Clinic.
Today, I’d like to share the story of a remarkable patient who endured 15 years and eight rhinoplasty procedures before finding a resolution to persistent nasal contracture and obstruction. This case illustrates the importance of a tailored, systematic approach to complex revision rhinoplasty.
Design Consultation: Frontal View, Left Side View, and Oblique Side View Photos
1. Surgical History
15 years ago: Gore-Tex + ear cartilage (overly natural appearance led to revision).
14 years ago: L-shaped silicone + ear cartilage (contracture and upturned nasal tip).
12 years ago: Autologous rib cartilage + dermal fat graft from buttocks (nose at risk of collapse).
11 years ago: Rib cartilage + septal cartilage, no implant (wide nasal dorsum).
10 years ago: AlloDerm (allergic reaction).
9 years ago: AlloDerm removal + additional rib cartilage.
2 years ago: Existing materials reused + dermal graft + ear cartilage.
1 year ago: Fat grafting followed by monthly dermal injections (7–8 sessions).
Key points include an allergic reaction to AlloDerm during the fifth surgery and severe septal cartilage damage.
Design Consultation: Right Side View, Oblique Side View, and Nostril View Photos
2. Key Challenges
Severe septal cartilage damage.
Upturned nasal tip.
Bilateral alar pinching.
Irregular nasal tip cartilage.
Asymmetric nostrils.
Severe nasal obstruction.
Dorsal depression.
3. Surgical Plan
a. Structural Reconstruction
Complete septal reconstruction using autologous rib cartilage.
Correction of upturned nasal tip.
Alar cartilage reconstruction.
b. Soft Tissue Refinement
Dermal grafts to restore alar shape.
Correction of nasal tip irregularities.
Scar tissue removal.
c. Functional Improvement
Septal reconstruction to restore external nasal valve function.
Correction of nostril asymmetry.
Resolution of nasal obstruction.
d. Dorsal Augmentation
Removal of scar tissue.
Creation of a smooth and straight nasal dorsum.
4. Surgical Outcomes
Despite the complexity of this case, the surgery proceeded smoothly, achieving significant improvements in both function and aesthetics:
Before (Left) / Immediately After (Right)
a. Structural Improvements
Stable septal reconstruction, providing a strong foundation.
Natural positioning of the nasal tip.
Restored and symmetric alar shape.
Before (Left) / Immediately After (Right)
b. Functional Recovery
Complete resolution of nasal obstruction.
Widened nasal airway.
Restored breathing capacity.
Before (Left) / Immediately After (Right)
c. Aesthetic Enhancements
Smooth and symmetrical nasal dorsum.
Natural-looking nasal tip.
Corrected nostril asymmetry.
Before (Left) / Immediately After (Right)
5. Expert Insights
This case required a precise understanding of the multiple complications arising from repeated surgeries. The following principles were critical to the success of this procedure:
Accurate Diagnosis and Planning: Each layer of damage and structural defect was addressed with a specific solution.
Comprehensive Septal Reconstruction: This was the cornerstone of both structural stability and functional restoration.
Soft Tissue Management: Meticulous handling of scar tissue and dermal grafting ensured a natural and smooth outcome.
Immediately After Surgery: Frontal, Oblique Side, and Side View Photos
Immediately After Surgery: Nostril View Photos
6. Closing Thoughts
This patient’s journey underscores the challenges of complex revision rhinoplasty. However, with the right expertise, even the most intricate cases can achieve satisfying outcomes. At Nose Lab Clinic, we are committed to providing tailored, high-quality care to patients facing similar challenges.
Thank you for taking the time to learn about this case. For consultations or more information, please don’t hesitate to reach out.
Best regards,
Dr. Cha-Young Kang
Director, Nose Lab Clinic
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