1. Pre-surgery design

This patient had a rhinoplasty 12 years ago, but had the implant removed due to inflammation only 1 year after the surgery. During all this time, the nostrils became uneven and extremely visible. The patient came to the clinic to fix those parts. 

2. Surgery plan

This nose tip deformity is commonly observed in patients who underwent rhinoplasty, and later experienced inflammation, having to remove the prosthesis for treatment purposes. The nose tip is lifted up with a twist and the frontal nostril asymmetry becomes increasingly visible, this is the type of contracture deformity we are referring to. When doing surgery on these cases, it is very common that the normal cartilage is melted and only some parts remain, or that it is damaged and out of place. Exactly for this reason is why asymmetry occurs. Therefore, according to the degree of damage of this patient’s nose tip cartilage, it was planned to use the autologous rib cartilage to reconstruct the nose tip cartilage. Moreover, to fix the parts that look bent, it was planned to perform an external osteotomy, and an alar rim extension to correct the nostril asymmetry. 

3. After-surgery photos

4. A general review

This was an inflammation-related revision surgery. There are always risks that surgery using implants will cause inflammation, or foreign body reactions. Depending on each person’s immune system, foreign body reactions may occur, and if the reaction persists chronically or periodically, inflammation may occur. However, if appropriate treatment is given if foreign body reactions occur, contracture deformities or similar complications can be prevented. In particular, like in this patient’s case, that the implant had to be removed after inflammation occurs, it is commonly discovered during surgery that there is nose tip cartilage damage caused by inflammation, and thus cartilage reconstruction surgery becomes vitally necessary.

Noselab Plastic Surgery Clinic by Dr. Chayoung Kang