[GaNet Plastic Surgery Press Coverage] If contracture occurs after rhinoplasty, it can be treated with revision rhinoplasty using costal cartilage

If you underwent rhinoplasty

for cosmetic or functional purposes,

but the silicone used to raise

the bridge of the nose caused a problem

and contracture developed,

you should decide on the timing of revision surgery quickly

and proceed with implant removal

and revision surgery.

To learn about the causes and symptoms of contracture,

what materials are used for revision surgery,

and how recurrence can be prevented,

please read the press coverage article featuring

Dr. Baek In-su, CEO of GaNet Plastic Surgery.

Rhinoplasty improves the nose so that it looks higher and more refined. Most surgeries do not cause major problems, but in some cases, if the bridge was raised too aggressively out of excessive desire and the result did not suit the tissue, or if the silicone used during surgery caused problems, the side effect known as “contracture nose” can occur. When the nose contracts, it means that an inflammatory reaction has occurred, causing changes in shape such as a shorter nose length and an upturned nose. It should not be left untreated, and revision rhinoplasty should be considered.

Unlike other cosmetic procedures, contracture nose surgery is approached from a treatment perspective with the goal of reconstructing the nose, which is why many patients decide to undergo revision surgery. Taking this into account, careful and accurate diagnosis is necessary so that the same surgery is not repeated.

The cause of contracture nose is generally silicone implants. The main symptoms include swelling between the eyebrows, a red nasal tip, a shortened nose, and small pimples on the nasal tip that do not heal easily. These can also be considered warning signs, and if this stage is missed, prompt action may become difficult. If you notice these symptoms, you should visit a plastic surgery clinic right away.

During revision rhinoplasty, the shape may be reconstructed again using silicone, but rather than reusing an implant that caused problems in the previous surgery, it is better to use autologous cartilage or autologous dermis, which can help avoid side effects.

In particular, among autologous cartilage options, costal cartilage is a commonly used autologous tissue material for revision surgery after nasal contracture. Because a large amount can be harvested and it is firm with a tendency to bend, the cartilage must be carefully and precisely refined in multiple thin layers, like slicing to balance the forces so that it does not warp, in order to raise the nasal bridge.

Of course, using silicone does not always cause side effects; this occurs only in some patients. Also, even if contracture has occurred once, it does not mean that it will definitely recur after revision surgery. However, it is important to identify the material used in the first surgery and the problems that occurred, and to ensure that similar issues do not repeat during revision surgery. If inflammation or contracture caused by silicone occurred in the previous surgery, the likelihood is higher during revision surgery, so this must be approached carefully and discussed thoroughly with the medical team.

The timing of revision rhinoplasty varies depending on the case. If the inflammation is severe or the contracture is severe enough to damage the skin, revision surgery should be performed immediately. However, if the implant has already been removed, or if the contracture has stopped progressing, revision surgery should be postponed and decided after allowing sufficient time. This is because, after surgery, the scar tissue often takes a long time to mature depending on the patient, and even a very small amount of inflammation left inside the nose may recover and improve over time.

During revision surgery, the skin and tissue remaining in the nose play an important role. If these remain stiff and do not loosen, it means the surgery has not fully settled, so it is generally recommended to wait at least six months after the first surgery and perform revision when the tissue becomes softer.

Dr. Baek In-su of GaNet Plastic Surgery said, “Because revision surgery for contracture nose is important not only as treatment but also for reconstructing the shape of the nose aesthetically, it is necessary to consult sufficiently with experienced medical staff with extensive related clinical experience and establish a surgical plan so that the problem does not recur. By closely analyzing the implant used and the current condition of the nose, a surgical plan is needed that can correct both the shape and function of the nose.”

Source: Medical Today https://mdtoday.co.kr/news/view/1065601963942139