Hello, this is Dr. Chayoung Kang, Director of Noselab Rhinoplasty Clinic. Today we will introduce a surgery case to improve nasal congestion and correct a contractured nose.
After undergoing several rhinoplasty surgeries, this patient had developed nasal congestion and contracture, which caused her great discomfort. The patient was especially concerned with the upturned nose, retracted columella, the visible nostrils, and others.
Preoperative Design Consultation
- Excessively visible nostrils
- Short nose
- Noticeable nose bone asymmetry
- Flat nasal bridge (implant had been removed)
- Unnatural nose bridge shape and upturned nose tip
- Wide nasolabial angle
- Unnatural nostril shape from the side profile view (unsatisfactory parts)
- Significantly depressed nasal bridge.
- Upturned nasal tip.
- Excessively thick columella.
- Evident nostril asymmetry
- Visible scar tissue on both sides of the columella
Patient’s medical history
- 10 years ago: surgery using silicone and ear cartilage
- 8 years ago: surgery using septal cartilage and silicone
- 5 years ago: silicone and donated rib, nostril reduction surgery.
- 1 year ago: self-rib cartilage and silicone, philtrum reduction surgery.
Surgical details
The following surgeries were performed through closed rhinoplasty.
a) Removal of the silicone implant (1st surgery – treatment for the contracture)
- Safe silicone implant removal.
b) Beginning of the stem cell treatment after the implant removal:
- 3 sessions of stem cell treatment during 3 months before surgery.
c) Autologous rib cartilage and transplant.
- Reconstruction of the nose tip using the rib cartilage, and septal cartilage extension graft and reconstruction.
d) Lateral osteotomy of the nasal bone.
- To improve the appearance of the wide nasal bone and the asymmetrical parts.
e) Septoplasty.
- Straightening the septum to improve the nasal congestion.
- After checking during the surgery, we confirmed that there was barely any septal cartilage left, so we performed septal cartilage reconstruction.
f) Turbinate submucosal resection
- To improve the symptoms of nasal congestion, we used a high-frequency laser to reduce the size of the thick inferior turbinates.
g) Nose tip correction
- Improvement of the considtion and lowering of the upturned nose tip through the septal extension graft and septal reconstruction.
h) Columella reconstruction.
- Improvement of the general balance of the nose through the reconstruction of the retracted columella.
All procedures were performed through closed rhinoplasty, completing the surgery without external scars.
Before and After Surgery Photos
- Adjustment of the excessively visible nostrils/
- The facial proportion improved by correcting the lenght of the short nose.
- A more balance appearance after correcting the nasal bone asymmetry.
- The previously plain nasal bridge took on a more natural shape.
- The previously unnatural nose shape and upturned nose tip became smoother and natural.
- Improvement of the harmony of the lips and nose tip through the nasolabial angle correction.
- Great improvement of the nostril shape to be more natural.
- Adjustment of the depressed nose bridge to become more three-dimensional.
- Enhancement of the overall balance of the nose by lowering the previously upturned nose tip.
- Improvement of the thickness of the columella.
- Great improvement of the nostril asymmetry.
- Reduction of the scar tissue on both sides of the columella.
After Surgery Table Photos
Overview
This case is a complex case that simultaneously resolved the structural nose and functional problems that appeared after multiple rhinoplasty surgeries. In particular, it was confirmed that the main cause of nasal congestion and upturned nose was the absence of septal cartilage. Reconstructive surgery using autologous costal cartilage has played a major role in securing structural stability of the nose and improving its functionality. It is thought that septoplasty and submucosal resection of the inferior turbinates can help solve nasal congestion issues and at the same time help improve some of the olfactory function.
The stem cell treatment appears to have had a positive effect in slowing the progression of the contracture, controlling any remaining inflammation, and gently regenerating the hardened skin. This was a great help in improving the contractured condition.
By using a closed rhinoplasty approach, tissue damage was minimized, and the bleeding and damage to blood vessels was minimal, so the risk of inflammation during recovery is expected to be very low. In this regard, the risk of deformation in the future is thought to be very low. Those who are considering rhinoplasty, especially those considering revision surgery, should consult with a specialist to find the method that best suits them. Noselab Clinic will share your concerns and suggest the best solution.
With Noselab Rhinoplasty Clinic you can achieve a beautiful and healthy nose.
Thank you.
Noselab Rhinoplasty Clinic
Dr. Chayoung Kang.
https://blog.naver.com/cykang/223520601343
https://noselabps.co.kr/category/before-after/short-upturned-nose
