[Nose Lab Clinic]
Hello, this is Dr. Cha-Young Kang, Director of Nose Lab Clinic.
Today, I’d like to introduce a case where autologous dermis grafting was used to correct a sharp nasal tip and cartilage show-through. This patient had undergone multiple prior surgeries, leading to thinned nasal skin, exposed cartilage, and structural instability, which required a careful and customized revision approach.
Design Consultation: Frontal View, Left Side View, and Oblique Side View Photos
1. Patient History & Initial Examination
a. Past Surgical History
✔ 7-8 years ago: Filler injection (later dissolved)
✔ 3 years ago: Septal cartilage + ear cartilage (tip graft)
✔ March 2024: Silicone + rib cartilage
✔ August 2024: Alloderm + cartilage refinement
b. Preoperative Observations
Structural Issues
✔ Thinned nasal skin at the tip
✔ Cartilage show-through causing unnatural appearance
✔ Overly sharp and pointed nasal tip✔ Elongated nose shape
Aesthetic Concerns
✔ Mildly deviated nose
✔ Narrow nasal bridge and tip
✔ Excessive nostril exposure
✔ Thin columella
Functional Issues
✔ Chronic nasal congestion
✔ Allergic rhinitis symptoms
Design Consultation: Right Side View, Oblique Side View, and Nostril View Photos
2. Patient’s Surgical Goals
🔹 Softening the overly pointed nasal tip
🔹 Reducing excessive nostril show
🔹 Columella repositioning for a more balanced nasolabial angle
🔹 Eliminating cartilage show-through for a smoother, natural look
3. Surgical Plan & Execution
a. Structural Reinforcement
✔ Lateral osteotomy to correct nasal deviation
✔ Harvesting autologous dermis from the postauricular area (behind the ear)
✔ Dermis graft placement at the nasal tip to thicken and reinforce the skin
b. Aesthetic Refinement
✔ Columella elevation for better nasolabial angle balance
✔ Reshaping the nasal tip for a softer, more natural contour
✔ Slight widening of the nasal tip and bridge to enhance overall harmony
c. Functional Enhancement
✔ Treatment of allergic rhinitis
✔ Correction of nasal airway obstruction
✔ Ensuring structural stability for long-term functional improvement
4. Postoperative Results
Before (Left) / Immediately After (Right)
a. Frontal View
✔ Smoother, softer nasal tip
✔ More natural nasal width
✔ Balanced nasal lines and proportions
Before (Left) / Immediately After (Right)
b. Side View
✔ Refined tip with reduced projection
✔ Stabilized columella position
✔ Improved nasolabial angle for a more harmonious profile
Before (Left) / Immediately After (Right)
c. Functional Outcomes
✔ Enhanced breathing capability
✔ Reduced nasal congestion
✔ Long-term structural stability
Before (Left) / Immediately After (Right)
5. Expert Insights – Why This Case Required a Specialized Approach
🔸 Challenges & Key Considerations
1️⃣ Thinned nasal skin after multiple surgeries – Without proper reinforcement, further revision could lead to skin translucency or tip instability.
2️⃣ Cartilage show-through correction – Simply shaving down the cartilage could have weakened nasal structure, so dermis grafting was the optimal choice.
3️⃣ Achieving balance between function and aesthetics – The patient’s desire for a natural-looking revision had to be balanced with structural and functional integrity.
🔹 Key Takeaways
✅ Autologous dermis grafting is ideal for nasal tip refinement in revision rhinoplasty.
✅ Preserving skin integrity and nasal function is crucial when dealing with thin skin and cartilage show-through.
✅ Even small refinements, when done correctly, can significantly improve overall facial harmony.
6. Final Thoughts – Achieving Natural & Long-Term Stability
Immediately After Surgery: Frontal, Side, and Oblique Side View Photos
Immediately After Surgery: Nostril View Photos
This case highlights the importance of precision and expertise in revision rhinoplasty. The patient achieved:
🔹 A softer, more natural nasal tip without excessive projection
🔹 Elimination of cartilage show-through through dermis grafting
🔹 Enhanced breathing function and nasal balance
At Nose Lab Clinic, we focus on tailored surgical strategies to address each patient’s unique needs, ensuring the best possible aesthetic and functional outcomes.
Dr. Cha-Young Kang
Director, Nose Lab Clinic
Thank you.
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