Contracted Nose Correction Case B #ContractedNoseSurgery

After augmentation rhinoplasty with silicone, contracture can develop gradually without the patient noticing,

and quite a few patients come to us after being told at some point, “Your nose looks upturned.”

The following patient also had no particular symptoms for 10 years, then visited us after being told one day that the nose had turned upward.

In such cases, in addition to the shortened nasal length, the tip often looks blunt

and cut off, and it is important to correct this.

Patients often struggle with whether to remove the silicone and only lengthen the upturned tip,

or whether it would be better to place something for the height of the nasal bridge.

This is because they worry that placing something might again lead to contracture or a chronic inflammatory response.

What helps greatly in resolving this concern is acellular dermal matrix (MegaDerm).

This is because MegaDerm has the lowest absorption rate among acellular dermal matrices, is a material resistant to inflammation,

and, in patients whose skin has thinned, also has the effect of reinforcing skin thickness.

PH

10 years ago, at another clinic: augmentation rhinoplasty with a 4 mm silicone implant (open approach)

CC

The nose had turned up slightly compared with immediately after surgery.

P/E

The nasal tip was upturned and blunt.

Thick scar tissue on the dorsum. No fluid accumulation or swelling.

The dorsum was thick and bunched up because of contracture and scar tissue.

​

The nasal tip is markedly upturned and looks blunt.

Preop

The nasal tip was upturned, with nostril show 

The dorsum is thick, and the outline of the silicone is visible --- due to contracture.

Postop

The upturned tip and the nostril show are gone.

The nose has been markedly lengthened. The dorsum has become slim and straight.

* When placing acellular dermal matrix, it is important not to make the starting point of the nose too high.

After surgery, the symmetry of the columella and nostrils also improved greatly.

After surgery, the nose has been sufficiently lengthened, and the tip, which had looked cut off, now extends slim and well defined.