Rhinoplasty Side Effect: "Contracted Nose" Correction with Autologous Costal Cartilage

A Case of Contracted Nose Correction with Autologous Costal Cartilage

A contracted nose is a condition in which, after rhinoplasty with silicone,

a chronic inflammatory reaction persists in the nose for a long time,

the soft tissue around the silicone shrinks,

and the nose shortens and the tip becomes deformed.

It is corrected by using autologous cartilage such as costal cartilage, septal cartilage, or ear cartilage

to lengthen the framework of the nose.

Past History: 15 years ago, silicone and Medpor (open approach)

were used for rhinoplasty,

and 10 years ago, the nose swelled and became inflamed,

so the silicone was removed.

Chief Complaint: For the past 8 years the nose had been turning up,

and the patient complained that it was pinched, twisted, and tilted.

PE: The nose was markedly shortened and upturned,

with columellar retraction and a pinched, tilted, and twisted tip

that were conspicuous.

OP: The remaining capsule on the dorsum and the Medpor at the tip were removed,

an L-strut, lateral crural strut grafts, and other grafts were made with costal cartilage,

and the nose was lengthened and the tip deformity corrected.

Augmentation of the dorsum was performed with acellular dermal matrix.

The columellar retraction and tip pinching 

can be seen to have improved.

The tilted, twisted nose has also improved.

The nose that had been upturned by contracture

has also stably returned to its proper position.