Pinched Nasal Tip and Nostril Retraction (Pinching & Notching) 01

Quite a few people want to have a silicone nasal implant removed but hesitate after hearing that, once it is removed, the tip may look pinched

or the nostrils may become retracted.

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If this kind of pinched-tip deformity (Pinching, Notching) actually appears after surgery,

what are the causes and solutions? Let us look at them closely through cases.

1. To prevent the capsule remaining inside the nose (silicone capsule) from causing contracture

and lifting the tip, and to release, even slightly, any contracture that has already occurred.

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2. Through tip cartilage repositioning, to release tip cartilages that were pinched when they were sutured together or

fixed to a strut during the previous surgery, so that the tip becomes natural.

Compared with method B, method A is naturally less effective at correcting pinching and retraction.

In other words, A can be expected to keep the condition from worsening and bring slight improvement,

while method B can clearly release the pinched tip (Pinched tip, Nostril notching).

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However, with closed-approach simple repositioning, because the tip cartilages were damaged and

deformed by the earlier surgery and are therefore weak, during the 3-6 month ​contraction period after removal and repositioning,

the tip may become more pinched or turn up slightly.

In such cases, when nasal tip rehabilitation (massage, stretching, and tip mobility exercises) is combined with a nostril support device (nasal retainer),

the pinched and retracted shape mostly recovers once the contraction period has passed.

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To help explain this, case photos are used as examples below.

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7-8 years ago at another clinic, through an open approach, this patient

had tip plasty with ear cartilage and silicone placed in the dorsum; contracture has now led to

a pinched tip, nostril notching, and an upturned nose, among other changes.

This patient had tip plasty with ear cartilage and augmentation of the nasal bridge with silicone at another clinic 5 years ago,

and developed a tilted columella (Shifted Columella), nostril notching, and, due to contracture,

an upturned tip. The pinching is relatively mild.

We have now seen what tip pinching, alar rim retraction (Nostril Notching),

and an upturned nose are.

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Now let us look at Won-Suk Kook Plastic Surgery's

cases of resolving the pinched tip and nostril retraction that occur after implant removal.

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P/H - This patient had rhinoplasty with silicone and ear cartilage at another clinic 8 years ago.

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C.C - Because of intermittent tightness and throbbing pain in the tip that began a month ago, the patient wanted the silicone implant

removed, but was very worried that the tip might become deformed after nasal implant removal.

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Physical Examination - The silicone implant was in its proper position, the tip was rather large and bulbous,

and an L-shaped silicone implant was in place with ear cartilage laid over the tip.

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