Revision Rhinoplasty Cases by Type 1 (Contracted Nose Caused by Silicone Infection)

Revision rhinoplasty refers to corrective surgery performed when, after one or more nasal surgeries,

aesthetic or functional side effects have developed.

The deformities that result from problems after rhinoplasty are so varied

that it is difficult to show every case one by one.

The reason is that the nose is a three-dimensional structure and a complex organ in which various tissues are organically connected.

We will therefore focus on representative cases and explain how, after revision surgery, side effects can be kept from recurring

and a good result can be achieved.

After removing the scar tissue and performing wide dissection to release the contracted skin and framework of the tip,

the nose was lengthened using autologous costal cartilage.

The dorsum was also augmented with costal cartilage, and the nasal length, dorsal height, and other features all improved to a satisfying degree.

Before surgery, the tip was pulled upward by contracture,

but in the photo taken after the contracture was corrected, the tip can be seen to have relaxed naturally.

The left-side view after surgery shows sufficient length and a natural nasal bridge.

Before surgery, the columella was crooked, something could be seen protruding inside the right side of the nose,

and there was slight pinching and notching.

The photo on the right, taken while the silicone was being removed, shows that the tip cartilages were twisted.

The dorsum, which was crooked before surgery, is now straight, and the nose can be seen to be longer.

Before surgery, the columella was crooked, which made the nostrils asymmetric,

but after surgery the columella has been straightened, and it and the nostrils are all symmetric.

The profile view confirms that the contracture has improved; the nose is now sufficiently long,

and the dorsum can be seen to have improved to a natural, masculine look.

Before surgery, the columella was markedly deviated, and there was also a great deal of thickened tissue at the tip.

After removing the dermal tissue and thickened tissue that had caused the contracture and fully releasing the tip, a derotation graft was performed with ear cartilage.

The dorsum was given natural height using acellular dermal matrix.

The blunt, bulbous tip is now well defined, and the tilt of the tip and columella has also improved.

The nostrils can be seen to have become naturally symmetric.

The upturned tip has come down, giving sufficient length, and the nasal bridge has been raised to an appropriate height.