Dr. Hong Seong-taek's Surgery Notes :: For a contracted nose, make it soft again with regenerative injections before nose revision surgery

Hello, this is Mary Plastic Surgery Clinic, glad to meet you.

Dr. Hong Seong-taek's Surgery Notes

Starting over with a contracted nose through softening injections

— Sharing a revision surgery case after PRP-based “softening injection”

“Your nasal tip keeps turning upward and becoming hard... It was fine at first, though.”

A nose that developed contraction over time after nose surgery done years or even decades ago Rather than simply repeating revision surgery, a nose reconstruction strategy that prepares the tissue for recovery is needed.

@dr_hong_banjang

💬 Patient memo

Consultation and examination results: contracted nose that developed after septum + silicone surgery

Discomfort symptoms: the nasal tip is rising, becoming shorter, and the nose is in a hardened state

First procedure: 1 PRP-based regenerative injection (Mary Softening Injection)

  → Restored tissue flexibility, the nose became soft again

Revision surgery plan

  - Donor costal cartilage for central support

  - Ear cartilage to shape the details

  - Reinsertion of silicone implant

  - Nasal bone osteotomy to correct the overall axis

Surgical difficulty: scar tissue and severe adhesion, reduced tissue elasticity

Explained directly by Dr. Hong Seong-taek

Key points of the surgery

1️⃣ Restoring nasal tissue, starting with the softening injection

Tissue that has already become hardened cannot be resolved by surgery alone.

At Mary Plastic Surgery Clinic, we first use a PRP-based autologous serum regenerative injection (softening injection)

to make the tissue soft and return it to a condition suitable for surgery before approaching it again.

PRP (Platelet Rich Plasma), the key ingredient of Mary Softening Injection, is platelet-concentrated serum with research findings showing that it promotes tissue regeneration and suppresses fibrosis (hardening).

Source: KoreaMed “PRP in tissue remodeling and fibrosis modulation”

Mary Softening Injection diagram

2️⃣ A contracted nose that does not stretch needs a different strategy

This case was especially challenging because there was a lot of scar tissue and the skin did not stretch well.

So I used three of my own strategies.

1. Lowering the starting point of the nose to achieve a natural flow from the forehead to the nose line

2. Strongly supporting the nasal tip with donor costal cartilage and creating a soft shape with ear cartilage

3. Smoothly connecting the bridge with a silicone implant​

What is the key point of this surgery?

I think it is not simply a surgery to “raise” the nose, but a design that considers both proportion and tissue flexibility.

3️⃣ Realigning the overall axis with nasal bone osteotomy

To correct the left-right asymmetry and deviation of the central axis caused by the previous surgery, nasal bone osteotomy was performed together.

→ A stable line aligned from the nasal bridge to the nasal tip to the lip line was completed.

A contracted nose is not something that is simply cut and raised again.

Before surgery, the tissue needs to be prepared in a recovered state in advance for good results.

The softening injection reflects Mary Plastic Surgery Clinic’s basic philosophy: “Recovery first, surgery second.”"

When it comes to revision surgery for a contracted nose, the following are the kinds of patients who often come to me for consultation.

“Everything was fine at first, but over time my nose keeps turning upward.”

“My nasal tip has become harder and harder, and it doesn’t move even when I press on it.”

“I had revision surgery, but my nose still looks unnatural and feels hard.”

“My skin has become thinner, and the implant is showing through.”

Most of the people who come in with these concerns are in a state where recovery is needed before surgery.

Wrapping up today’s surgery note

Nose revision surgery, especially when contraction is involved, cannot be solved by simple or repeated surgery alone.

We accurately analyze each patient’s tissue condition and, if necessary, first restore it with regenerative injections before proceeding with surgery.

The “softening injection” is not just an injection, but the starting point for a good revision surgery result.

If you have any questions, please leave a comment on the blog or contact us after adding us as a neighbor. It is best to consult directly with a specialist for medical counseling.

This has been Mary Plastic Surgery Clinic, glad to meet you. ​