Q. Why Does Contracture Occur After Rhinoplasty? Can It Be Prevented?

Hello, this is AB Plastic Surgery.

Today, we will look at why contracture occurs after rhinoplasty and whether it can be prevented.

Q. Why Does Contracture Occur After Rhinoplasty? Can It Be Prevented?

Contracture refers to a condition in which the skin, soft tissue, cartilage, and other structures contract after nasal surgery, causing the nose to become shorter or harder.

Contracture is a complication that usually results from the combined effects of multiple factors rather than from a single cause.

1. Infection and Chronic Inflammation

Infection after surgery or persistent inflammation can promote the formation of scar tissue and a capsule, increasing the risk of contracture.

2. Excessive Scar Tissue Formation (Fibrosis)

During the healing process, excessive collagen production and contraction of scar tissue may lead to contracture.

Individual characteristics and differences in wound-healing patterns can also have an effect.

3. Capsular Contracture Around an Implant

A thin capsule naturally forms around implants such as silicone.

In some cases, this capsule may thicken and contract, resulting in contracture.

4. Excessive Tissue Damage

If dissection is performed more extensively than necessary or excessive soft-tissue damage occurs, the scar response may increase.

In addition, if a hematoma or impaired blood circulation develops, normal tissue recovery may become more difficult, potentially increasing the risk of contracture.

5. Insufficient Structural Support

If the cartilage structure supporting the nose is not strong enough, it may be unable to withstand the contractile forces that develop during healing.

This can lead to deformities such as a drooping nasal tip or a shortened nose.

6. Repeated Revision Surgery

Repeated surgery before the tissue has fully recovered can result in the accumulation of scar tissue and may increase the likelihood of contracture.

7. Smoking

Smoking reduces peripheral blood circulation, interferes with wound healing, and may increase the risk of infection and inflammation.

So, how can contracture be prevented?

• Sufficient Preoperative Consultation and an Appropriate Surgical Plan

It is important to thoroughly analyze the patient’s skin thickness, soft-tissue condition, and existing nasal structure before selecting an appropriate surgical method and materials.

Recently, efforts have been made to reduce hematoma formation and excessive scar reactions and to lower the likelihood of contracture by using 3D customized implants (Ssofit and Fitme) designed to fit more closely against the nasal framework, as well as implants (Moriet) featuring a micro-textured surface and wing structure.

• Precise Surgery

Dissection should be performed only within the necessary range while minimizing unnecessary tissue damage. A stable supporting structure should also be created using septal cartilage or costal cartilage so that it can adequately resist the contractile forces that develop during healing.

• Prevention of Infection and Inflammation

The risk of infection can be reduced through appropriate hygiene before and after surgery and, when necessary, the use of prophylactic antibiotics. Regular follow-up is also important to detect abnormal findings early and provide appropriate treatment.

• Abstaining from Smoking and Alcohol

It is recommended to avoid smoking and alcohol for at least four weeks. If possible, maintaining abstinence for longer may further support wound healing.

• Sufficient Rest and Nutrition

Adequate sleep and a balanced diet during the recovery period can help support normal wound healing and maintain immune function.