[Nose Lab Clinic]
Hello, this is Dr. Cha-Young Kang from Nose Lab Clinic.
Today, I’d like to introduce a case of a wide nasal bridge and an upturned nose, corrected using donor rib cartilage reconstruction. This patient had undergone multiple previous surgeries, experiencing complications related to implant reactions and nasal bridge widening.
Design Consultation: Frontal View, Left Side View, and Oblique Side View Photos
1. Surgical History
✔ 10 years ago: Auricular cartilage + silicone implant
✔ 2 months later: Implant removal due to a foreign body reaction (fluid accumulation)
✔ 5 years ago: Silicone + septal cartilage graft
✔ 3 years ago: Silicone + donor rib cartilage graft
✔ Nasal bridge thread lifting: Resulting in an adverse reaction
✔ 6 months ago: Complete removal of previous materials + autologous rib cartilage reconstruction
2. Initial Assessment
Design Consultation: Right Side View, Oblique Side View, and Nostril View Photos
a. Functional Concerns
✔ Right-sided nasal obstruction
✔ Compromised nasal septum
b. Aesthetic Concerns
✔ Wide, broad nasal bridge
✔ Over-rotated (upturned) nasal tip
✔ CT scan indicated an excessively high nasal bridge from previous surgeries
3. Patient’s Goals
✔ Refinement of the broad nasal bridge
✔ Correction of the over-rotated tip
✔ Avoidance of silicone implants
✔ Preference for donor rib cartilage over autologous cartilage
4. Surgical Plan & Execution
a. Foreign Material Removal & Precision Analysis
✔ CT scan evaluation to assess residual foreign material
✔ Complete removal of remaining thread lift materials & filler remnants
Photos of Removed Foreign Materials
b. Wide Nasal Bridge Refinement
✔ Osteotomy (lateral bone repositioning) to create a balanced nasal width
✔ Reshaping of the nasal dorsum for a sleeker contour
✔ Donor rib cartilage grafting to achieve controlled augmentation
c. Upturned Nose Correction
✔ Adjustment of nasal tip rotation to achieve a natural, proportional position
✔ Maximal preservation of existing autologous rib cartilage for stability
✔ Additional donor rib cartilage grafting to reinforce deficient areas
✔ Septal reconstruction for long-term structural integrity
5. Post-Surgical Outcomes
Before (Left) / Immediately After (Right)
a. Frontal View
✔ Slimmer nasal bridge with refined width
✔ Balanced symmetry and improved proportions
Before (Left) / Immediately After (Right)
b. Lateral View
✔ Corrected tip rotation (no longer over-rotated)
✔ Harmonized dorsal height with natural curvature
✔ More proportionate nasal tip position
Before (Left) / Immediately After (Right)
c. Functional Improvement
✔ Alleviated nasal obstruction
✔ Stabilized septal support
✔ Reduced risk of foreign body reactions
Before (Left) / Immediately After (Right)
6. Expert Insights
Immediately After Surgery: Frontal, Side, and Oblique Side View Photos
Immediately After Surgery: Nostril View Photos
This case was particularly challenging due to multiple prior surgeries and persistent foreign body reactions from implants and thread lifting procedures.
Key points of focus included:
✔ Avoiding further complications from synthetic materials by exclusively using donor rib cartilage
✔ Balancing nasal width using osteotomy and controlled dorsal augmentation
✔ Ensuring structural stability while correcting an over-rotated nasal tip
By utilizing previously preserved autologous rib cartilage where possible and reinforcing deficiencies with donor rib cartilage, we successfully achieved a functional and aesthetic improvement with long-term structural integrity.
This is Dr. Cha-Young Kang, Chief Surgeon at Nose Lab Clinic.
Thank you.
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