Correction of an Upturned Nose and Pinched Tip Caused by Silicone Contracture
A "contracted nose" refers to a condition in which, after rhinoplasty with silicone, a chronic inflammatory response around the silicone
thickens the capsule and scar tissue, the skin shrinks, and the tip cartilages are gradually pulled upward.
When the tip cartilages are pulled up by contracture in this way,
the nose not only becomes shorter, but the tip cartilages are also crushed together and deformed into a pinched shape.
Correction of a contracted nose must therefore, along with the upturned nose,
carefully assess and also correct the pinching of the tip (pinched tip).
Chief Complaint
Contracted nose
Past History
20 years ago, augmentation rhinoplasty with silicone at another clinic
▶ Afterward, tenderness and a tight feeling around the glabella. The nostrils were visible, and the patient was dissatisfied with the shape
4 years ago, at a clinic in Gangnam: silicone for the bridge + septal cartilage for the tip (columellar strut, tip onlay)
▶ The nose looked attractive after surgery but gradually became shorter.
▶ From 1 year after surgery, swelling and pain in the glabella (6-7 episodes). A severe inflammatory reaction 15 days ago, with swelling extending to the eyes.
Physical Examination
· The silicone on the dorsum has moved upward, and the outline of the implant is visible.
· The capsule and scar tissue are thick, so the nasal bridge is wide and bulky.
· In the photo on the right, the nostril is pulled upward and looks elongated and pointed,
and the phenomenon known as notching is also seen.
In the lateral view, the columella is flat and the nasal tip is pulled markedly upward.
This is the typical appearance of a "contracted nose," and it was improved by removing the silicone, the thickened capsule, the scar tissue, and other such tissue.
A thick capsule covers the area around the silicone, and the tip cartilages have been drawn together and narrowed.
▶ This gives the tip a pinched appearance (pinched tip).
The photo on the right shows the state after all of the silicone and capsule were removed to resolve the problem.
- Separating the deformed tip cartilages, which were entangled with each other and with scar tissue
- After a butterfly graft using ear cartilage
The dorsum and tip, which had been bulky and unnatural because of contracture, are now slimmer.
The excessive nostril show has also been naturally concealed as the nose lengthened, and the notching is gone.
The nasal tip, which had been pulled up into a point, has been released and has settled naturally.
By removing the silicone implant, which had moved upward because of contracture, and the capsule,
the dorsum has become slim and relaxed.
The tip has come down and lengthened, the upturned nose has been corrected, and the dorsal line also looks natural.
In the lateral view, the previously upturned nose has clearly come down.