[Contracted Nose] Making the Impossible Possible! Revision Surgery for Contracted Nose

Contracted Nose Revision Surgery at April 31 Plastic Surgery

Hello,

This is April 31 Plastic Surgery.

Today, we will take a look at revision surgery for contracted nose.

Contracted nose revision surgery requires highly advanced techniques and very complex surgical skills, so we will explain it in separate parts.

What is a contracted nose? Definition and causes

A contracted nose refers to a condition in which, as a result of inflammation caused by repeated nasal surgeries, foreign-body reactions, infections, or other complications from implants, the tissue turns into scar tissue, making the nose hard and gradually causing the tip to lift or become distorted.

It can occur when excessive scar tissue develops due to inflammation, foreign-body reactions, hematoma, or other causes related to implants or other graft materials.

It is also commonly caused by contraction due to excessive skin tension from using implants that are too large, as well as excessive scarring caused by repeated surgeries.

Recently, contraction caused by fillers and thread materials has also been occurring often.

Will it recur after contracted nose surgery?

As explained above, the main cause of contracted nose is infection and inflammation caused by foreign-body reactions. Therefore, contracted nose surgery should be performed using the patient’s own autologous tissue, which can help prevent recurrence.

Autologous tissue includes ear cartilage, septal cartilage, costal cartilage, autologous dermal tissue, and autologous fascia tissue.

Because surgery is performed using the patient’s own autologous tissue, there is no inflammation from foreign-body reactions, which can help prevent recurrence of contraction.

Why has the rate of contracted nose revision surgery recently increased?

Past rhinoplasty vs. recent rhinoplasty

First reason: Increased surgical refinement

In the past, rhinoplasty was very simple.

By inserting a shaped implant, doctors could quickly create a desired shape in a short surgery time and transform many patients. However, in recent years, more procedures have been performed that change not only the skin but also the support structure that holds up the nose.

By altering the structure, a more natural appearance and a variety of shape changes can be achieved, but if things go wrong, the severity of complications can become more varied and more serious.

Second reason: Inappropriate use of various new materials

Many materials have been developed to replace tissues needed for rhinoplasty. These include silicone, Gore-Tex, AlloDerm, MegaDerm, and Medpor.

The safety of silicone and Gore-Tex has reached a level close to that of autologous materials, and the safety of other materials has also been established through experiments and various medical clinical studies, but they should be used only in a limited manner when changing the support structure during nose surgery.

There are now more side effects caused by using excessive amounts or using them in inappropriate areas, and many cases progress into contracted deformity.

Differences between contracted nose correction surgery and general revision rhinoplasty

Unlike general revision rhinoplasty, contracted nose revision surgery has a process that must be performed.

① Dissection and release → ② Cartilage structure dissection → ③ Fixation → ③ Grafting → ④ Dressing and splinting

Skin dissection is necessary to sufficiently cover the cartilage.

The contracted and distorted cartilage structure is dissected and moved into the correct position, and fixation is performed in the newly corrected position, using ear cartilage, septal cartilage, or costal cartilage at this stage.

The key point here is that the material used to fix the new position must be autologous tissue to prevent recurrence.

Next, appropriate grafting is performed to create the shape of the nasal bridge and tip.

If there are no problems, a silicone implant is used, but for severe contracted nose, autologous dermis is often used, and fascia from behind the ear or the temporal region may also be used.

Finally, dressing and splinting are performed to help the surgery recover stably, and this is the stage where a management program is applied to stabilize the scar tissue.

When contracted nose surgery is needed and various symptoms

Self-diagnosis Check!

✔ The nostrils are very visible and the nose is lifted ✔ The nose has become stiff, does not move, and feels hard ✔ The nose turns red or feels warm ✔ There is a bad smell from inside the nose or discomfort ✔ The nose feels tight or painful ✔ The silicone is bent or has shifted toward the glabella ✔ There is a boundary around the implant

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If even one of these symptoms applies, it is best to consult a medical professional as soon as possible.

April 31 Plastic Surgery Contracted Nose Revision Self-Diagnosis

Today, we briefly looked at revision surgery for contracted nose.

Next time, we will come back with a more detailed discussion about contracted nose.