Carefully Consider a Secondary Procedure for Contracted Nose

Solutions aimed at improving appearance had been carried out for quite some time.

The shape right after the procedure was satisfying, but as time passed, the nose could become shorter and side effects such as nostril retraction often occurred.

When the soft tissue inside the nose contracted, the nasal cavity could become blocked, making it difficult to breathe. If functional problems arose, corrective surgery was inevitably performed. A contracted nose was a highly complex solution with the goal of not only improving aesthetics but also restoring function.

1. Why does the nose contract?

Before moving on to reconstruction, the reason the contracted nose occurred had to be clearly identified.

Repeated inflammatory reactions inside the nose caused a capsule to form around the implant. This then hardened into scar tissue, pulling on the surrounding tissue and causing the vertical length to shorten and the shape to become distorted. Although this is the general mechanism behind contracture, it differs slightly from person to person, so a precise individual analysis was essential.

It was necessary to understand not only the patient’s skin texture and constitution, but also the characteristics of the materials used in the past.

2. Materials used for reconstruction

The 대표적인 materials that cause a contracted nose were silicone and Gore-Tex. Although these implants were recognized for their stability, inflammation or deformation could still occur due to differences in each person’s immune response.

To compensate for the shortcomings of artificial materials, materials harvested from the patient’s own body were used during reconstruction. However, even when autologous materials were used, problems such as infection or absorption could still arise, so suitable alternatives had to be prepared.

These days, septal cartilage, ear cartilage, and rib cartilage are often preferred.

It was necessary to secure extra material in anticipation of absorption. Since it is difficult to obtain tissue again from an area that has already been harvested once, rib cartilage, which can provide a relatively large amount, has generally been used more often.

Rib cartilage is the cartilage between the ribs and can be obtained from the rib cage. It had to be understood in advance that pain or scarring could occur during the harvesting process. Although traces may remain in the chest area, it has been recognized as the hardest, most stable, and least absorbable material, so its use has gradually increased.

A high level of preference did not mean that the processing method was easy. From harvesting to processing and insertion, high-difficulty techniques were required, so it was important to get help from medical staff with excellent skills and extensive experience.

Depending on the condition of the contracted nose, auxiliary materials such as cartilage, dermis, and fat were sometimes used together. These were used when the skin had become thin and the internal framework was visible, or when a refined shape needed to be created. Ear cartilage and septal cartilage are also materials that are often used, but if they had already been used in the past and were insufficient in quantity, rib cartilage or donated materials could be processed and inserted.

3. When to decide on a retry

As the nose shape gradually changed abnormally, patients often became anxious and wanted to retry as soon as possible, even for just one more day.

Unlike the first procedure, reconstruction could not be done immediately at the time a person decided. Since the inside had already been incised and damaged, it was a priority to wait until the tissue stabilized.

Only after the inflammatory reaction subsided and the incision area had healed sufficiently could the tissue be resected again safely. The timing of reconstruction was generally determined after waiting about 6 months to 1 year.

4. Procedure time and retry cost

As mentioned earlier, a contracted nose requires advanced technique, so the procedure usually takes longer than the first attempt.

If the usual procedure takes about 1 hour to 1 hour and 30 minutes, reconstruction may take at least 2 hours and up to 4 hours. The recovery period also has to be longer than the first time.

While major swelling and bruising usually subside within a week, allowing a return to daily life, those who undergo reconstruction may need even more time. The cost is also set higher, depending on the materials used.

5. Criteria for choosing a medical institution

When choosing a medical institution and the doctor in charge, it was essential to check what materials and techniques would be used to solve the problem, and whether they had handled many cases similar to mine.

In addition, it was very important to thoroughly check whether the doctor in charge personally handled everything from consultation to the solution and follow-up care process.

Of course, location and cost should also be considered, but for stable and satisfying results, it was wise to focus on the medical staff’s skill and the institution’s procedures when doing prior research.

To restore a deformed nose shape and achieve smooth recovery, it was also important to strictly follow aftercare guidelines.

To prevent infection and stabilize the damaged tissue, as much as possible, the area should not be touched and should be kept clean.

At this time, if strong external pressure or impact is applied, the mucosal and cartilage tissues may not settle properly or may become abnormally fixed. For that reason, strenuous exercise and massage therapy are best avoided.

The key to a contracted nose solution was to establish a treatment plan that comprehensively included the cartilage’s support, skin condition, and restoration of breathing function.

Depending on the patient’s condition, one reconstruction procedure alone may not be enough. Rather than rushing because of an obsession with quick recovery and a beautiful line, it was most important to allow the tissue to stabilize sufficiently and correct the nose without overdoing it.

In fact, more effort had to be put into prior research than into the first attempt. If help is received from a doctor with outstanding skills and broad experience, it may be possible to improve both function and appearance at the same time. More important than that was a mindset of looking far ahead and approaching the process carefully.

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