Is It Impossible to Avoid Contracture After Nose Surgery? Dr. Jang Wook Shares His Know-How

Is It Impossible to Avoid Contracture After Nose Surgery?

Dr. Jang Wook Shares His Know-How

Hello.

This is Obje Plastic Surgery.

There is a phrase that is often heard among people who are preparing for rhinoplasty or have already had surgery.

“Your nose tip will droop over time,” “Eventually, you’ll need a revision surgery.”

In fact, after rhinoplasty, there are not a few cases where the nose tip lowers or the shape changes.

So these kinds of comments can feel less like a simple rumor and more like a realistic concern.

But contracture after nose surgery or a drooping nose tip is not something that inevitably happens to everyone.

The longevity of rhinoplasty can vary greatly depending on how the nose-tip structure was designed at the time of surgery.

Today, we will go over why the shape of the nose changes after rhinoplasty,

and how it can be prevented, one step at a time.

If you read until the end, you’ll be able to identify the key points you should know before rhinoplasty.

A drooping nose tip is not a “matter of time”

To understand why the nose tip changes after rhinoplasty, you first need to know the condition immediately after surgery.

Right after surgery, swelling remains significantly, so the nose tip appears higher and sharper than it really is.

As the swelling goes down, the soft tissue settles back into place,

and during this process, you may feel that the nose tip has “slightly dropped.”

This is not something to worry about; it is a normal part of recovery.

If the medical team is experienced, they anticipate these changes from the beginning and design the height accordingly,

so that it settles into a natural position within 3 to 6 months.

What you should pay attention to starts here.

If, even 1 to 2 years after surgery, or even later, the nose tip drops noticeably or asymmetry appears,

that is not part of the recovery process. It happens because the support structure holding up the nose tip was not sufficient.

The nose tip is a structure made of cartilage, not bone.

The bridge of the nose can remain relatively firm because bone and silicone combine there,

but the nose tip has to be supported by cartilage alone,

so how firmly that cartilage structure is built determines the long-term ability to maintain the shape.

Simply put, for the nose tip, you do not just raise the height; you have to build a pillar.

If the pillar is weak, even if it looks beautiful at first, it may become structurally difficult to maintain over time.

If the pillar is strong, there is a high chance that the original shape will be maintained for years.

Why does contracture after nose surgery happen? I’ll tell you only the <core point>

Contracture after nose surgery refers to a phenomenon in which the shape of the nose changes as the capsule around an implant thickens.

To understand the cause of this phenomenon, you need to know what happens when an implant touches the nose tip.

In the past, methods such as L-shaped silicone or Gore-Tex, which connected the bridge of the nose to the nose tip with a single implant, were widely used.

With this method, because the implant reaches the nose tip, the skin at the tip is continuously pressed from the inside.

When skin is pressed continuously, it gradually becomes thinner.

Under thinned skin, the implant may become visible, or in severe cases, protrude.

That is not the end of it.

When our body is continuously stimulated by a foreign material, it reacts by trying to form a protective layer around it.

This protective layer is the capsule, and when the capsule gradually thickens and contracts, compressing the implant,

the nose tip may turn upward, harden, or become deformed asymmetrically.

This is the core process behind contracture after nose surgery.

In summary, with a structure where the implant reaches the nose tip,

skin irritation and capsule contraction occur at the same time, which increases the likelihood that the nose shape will change over time.

So then, in recent years, in what direction have surgical methods changed?

Surgical design that reduces contracture after nose surgery has changed like this

The biggest change in current rhinoplasty is that the nose tip and the bridge are approached separately.

Silicone is used on the bridge only when necessary,

and the nose tip is operated on by using autologous cartilage to build a support structure.

Because the implant does not directly touch the nose tip, the skin is less likely to be pressed and thinned,

and deformity caused by capsule contraction is also reduced.

What matters here is not simply removing the implant, but how the support structure is designed.

The structure supporting the nose tip is built using septal cartilage, donor cartilage, autologous rib cartilage, and similar materials,

and long-term stability depends on the strength and placement direction of that cartilage, and on how it is fixed.

If the cartilage is not sufficiently strong or the structure is not built stably,

even if it looks good at first, support may weaken over time and the nose tip may droop.

On the other hand, if it is structurally designed stably from the beginning,

there is a high chance that the original shape will be maintained even after several years.

That is why the statement, “rhinoplasty always requires revision surgery,” does not apply in every case.

Cases that end up needing revision surgery usually involve a support structure that was designed weakly,

or surgeries performed with an older method in which the implant touched the nose tip.

Today, we looked at why the nose shape changes after rhinoplasty, how contracture after nose surgery occurs,

and the direction of surgical design to reduce it.

A drooping nose tip or a changed shape is not a change caused by time alone;

it depends on how the structure was designed at the time of the initial surgery.

Dr. Jang Wook of Obje Plastic Surgery designs a cartilage-based support structure that does not allow the implant to touch the nose tip, and considers the strength and placement direction of the cartilage

so that the nose tip is less likely to droop even as time passes.

If you are considering rhinoplasty, rather than looking only at the height of the nose tip,

I recommend checking how the nose-tip support structure is designed.

This has been Obje Plastic Surgery.

Thank you.

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• This post contains medical information written by Obje Plastic Surgery Clinic in compliance with the Medical Advertising Act.

• Depending on the individual, treatment effects may vary, and side effects may occur. Please be sure to have a thorough consultation with the medical staff in advance before deciding on the procedure.