Hello, Iโm Dr. Cha-Young Kang, Director of Nose Lab Clinic.
Today, I will introduce the case of a patient who had developed nasal contracture and functional issues after undergoing several rhinoplasties.
๐ Surgical history
2010: Silicone, Ear Cartilage
January 2024: Autologous costal cartilage, silicone
July 2024: Reuse of costal cartilage, ear cartilage, silicone (subsequent 7 cyst aspirations and cleansing sessions)
August 2024: Silicone, costal cartilage removal
Currently taking medication
๐ Main Symptoms and Requirements
Improvement of the nasal contracture
Functional restoration
Relief of the congestion on the left side of the nose.
๐ง Pre-operative analysis
Frontal view
Wide nose bridge
Excessively visible nostrils
Nostril asymmetry
Short and deviated nose
Side profile
Nasal hump (beak-shaped)
Upturnedb nose
Retracted columella
Nostrils
Bilateral asymmetry
Columella tilted to the left side
Blunt-shaped nose tip
๐ Surgery details
This is the condition of the septal cartilage as checked during the surgery. The first picture is the current damaged septal cartilage, and the white part in the second picture is the remaining septal cartilage. The yellow part is the expected range of the original septal cartilage. It is judged that a significant part of the septum was damaged, causing the tip of the nose to be lifted and the columella sunk in.
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To address these issues, the following surgery was performed:
Reconstruction of the nasal structure
Complete reconstruction of the nasal septum using autologous costal cartilage
Removal of the contractured tissue
Alar cartilage reconstruction
Lowering of the left nostril
2. Shape improvement
Correction of the wide nose bridge through an external osteotomy
Raising the bridge of the nose with autologous costal cartilage
Deviated nose correction through a septal extension graft surgery.
Columella reconstruction.
Nasolabial angle correction.
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3. Functional improvement
Septal Deviation Correction
Submucosal resection of the inferior turbinates using a high-frequency laser (rhinitis surgery)
๐ก Expert opinion
The most important thing in severe contracture reconstruction is to accurately identify the causing agent of the contracture and completely removing it. It is best to remove as much contracture tissue as possible, and to sufficiently reconstruct damaged cartilage, as well as keeping meticulous management to prevent contracture from reoccuring.
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The following treatments are actively considered, especially to prevent postoperative nasal contracture:
Stem cell injection treatment
Antibiotic injection treatment
Hyperbaric oxygen therapy
Helium Laser Treatment
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An important part of nasal contracture reconstruction surgery is that both, the cosmetic and the functional aspects are taken into account. However, the most important thing in this surgery is reconstruction to achieve structural stability rather than just cosmetic improvement. Just as a beautiful building can only be completed when there is a solid foundation, a successful reconstruction surgery can greatly improve the results of subsequent cosmetic improvement surgeries.
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For this reason, in cases of severe nasal contracture, it is common to approach it in stages, with the first surgery stage being reconstructive, and the second stage being a cosmetic surgery. This is a strategic choice for safer and more stable results.
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Noselab Clinic will continue to provide this systematic and professional approach for the health and beauty of our patients.
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This was Kang Cha-young, Director of Noselab Rhinoplasty Clinic.
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