Correction of Contracted Nose Deformity After Silicone Rhinoplasty
PH
3 years ago, the patient underwent augmentation rhinoplasty with silicone and ear cartilage (closed approach).
CC
From the front, the nasal axis was deviated, the nostrils were highly visible (notching), and the dorsum was thick and wide.
From below, the septum and columella were out of alignment (septal deviation and columellar deviation), the nostrils were asymmetric, and the columella was tilted.
From the side, the nose was markedly upturned and shortened.
P/E
The dorsum was blunt and thick because of the silicone and the surrounding capsule and scar tissue. The nasal tip was deformed by contracture.
The nasal tip was upturned.
OP
Through an open approach, the silicone, capsule, scar tissue, and the ear cartilage at the tip were all removed, and the tip cartilages were
completely released so that they could extend downward; a columellar strut and an extension graft were then placed using ear cartilage.
The dorsum was augmented with acellular dermal matrix.
After Surgery
The nose has been sufficiently lengthened, the dorsum is slimmer, and the nostrils are much better covered.
The columella, which had been tilted, now stands straight, and the nostril asymmetry is markedly improved.
The nose has clearly been sufficiently lengthened. The dorsum looks natural, with no visible signs of surgery.
