Ninth Revision Rhinoplasty for Contracted Nose: Pinched Nose, Depression, Autologous Rib Cartilage, Saddle Nose

Hello, this is Chamin Plastic Surgery.

Today, we would like to review the case of a patient who came to Chamin for their ninth nose surgery.

What is a contracted nose?

A contracted nose refers to a condition in which, due to inflammation, foreign body reaction, and similar causes after surgery, the skin contracts, becomes firm, the tip of the nose turns up, and the overall length of the nose becomes shorter.

In the case of a contracted nose, if treatment is delayed or left untreated, the contracture can worsen, and it may even progress to a situation where nasal reconstruction is needed.

Prompt treatment is therefore necessary.

Ninth Revision Surgery Case for a Contracted Nose

Chamin Plastic Surgery Clinic

Before surgery

｜History of surgery at another clinic

About 12 years ago, after undergoing nose surgery, the silicone became bent. After a second surgery to correct the bent silicone, the nasal tip gradually became more upturned, and due to contracture, the silicone was removed.

After that, the tip lifted again due to contracture, so only the nasal tip was corrected with ear cartilage, but the problem still was not resolved, so the patient underwent four ear cartilage procedures and corrections on the nasal tip.

However, as the situation continued to worsen rather than improve, the patient came to Chamin Plastic Surgery to undergo a ninth nose surgery.

Before surgery

｜The patient’s condition before surgery

• Upturned nasal tip due to severe contracture
• Depression between the bridge and the tip of the nose
• Nostril pinching and nostril asymmetry
• Saddle nose shape caused by collapse of the septal cartilage
• A bumpy, wrinkled appearance of the nose

In noses that have undergone major deformity overall, the internal cartilage and structures are often not normal, and the skin itself is often dented and completely stiffened.

Condition of the septal cartilage / shape of the saddle nose

At the time of surgery, the inside of the patient’s nose was in a very severe contracted state, and the alar cartilages were all damaged, leaving no normal cartilage at all.

In particular, the patient said that the contracted nose had been extended several times with ear cartilage, but inside the nose there were cartilage pieces from unknown sources heavily attached to the nasal tip.

As a result, there was extensive damage to surrounding tissues and a large amount of severe scar tissue.

｜Chamin Plastic Surgery treatment plan

• Bridge of the nose: Alloderm (donor dermis)
• Nasal tip: Autologous rib cartilage
• Depressed area: Autologous dermis
• Pinched nasal tip: Scalp graft

After removing foreign materials from inside the nose, autologous rib cartilage was used to build a strong nasal support structure, and improvement was achieved through skin grafting in the nostril contracture and columellar depression areas.

One week after revision surgery for the contracted nose

Chamin Plastic Surgery Clinic

One week after revision surgery for the contracted nose

This is what it looked like one week after surgery. Although this is a period with significant swelling, the depressed area on the bridge has been well smoothed out, and since both the bridge and nasal tip were low before surgery, they were made as naturally elevated as possible, and overall the nose looks much more normal than before surgery.

Appearance before surgery and one month after surgery

Chamin Plastic Surgery Clinic

Before surgery / 1 month after surgery

From the front, the nostrils are much less visible, and the bumpy bridge and pinched nose have improved significantly.

The nasal tip, which had been deviated to the left, was also corrected as much as possible toward the center.

Before surgery / 1 month after surgery

The sunken bridge caused by the saddle nose was improved, and the nasal tip has also been well extended.

Before surgery / 1 month after surgery

From the side, the nasal tip is well projected, and the height of the nasal tip has also risen nicely.

In revision surgery for a contracted nose, it is very important to establish a strong nasal support structure.

Before surgery / 1 month after surgery

The deviated nasal tip was corrected, and the nostril asymmetry was also carefully improved as much as possible.

The patient had been very physically and mentally exhausted due to several previous nose revision surgeries, and said they did not have high expectations.

However, after the splint was removed and the swelling went down, the patient said, “Thank you so much. I didn’t know it would turn out like this.”

Before-and-after selfie photos The photos were posted with the patient’s consent, and unauthorized use or distribution is prohibited.

Selfie photo before surgery

2 months after revision surgery for the contracted nose

The nose is currently being maintained well without any deformity, and the patient is showing a good recovery.

[Case review of the ninth revision surgery for a contracted nose]

Chamin Plastic Surgery is a hospital that performs many revision and reconstructive nose surgeries, and we meet many patients who have been struggling emotionally for a long time after multiple nose surgeries.

Because we fully understand the feelings of those who are hesitating about revision nose surgery, we will do our best so that this can be your final surgery.

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