Rhinoplasty Korea

This patient had silicone implant on the dorsum and tip surgery with septal and conchal cartilage. As time passes, the tip and supratip area dropped and a step deformity of the dorsum developed. You can see the short silicone implant on the dorsum from the X-ray and the subsequent step deformity on the preoperative lateral view in the middle. Silicone was replaced with autologous cartilage and tip ptosis was corrected with cartilage support. It is sometimes difficult to expect how much the tip projection will decrease as time passes, but with proper technique using autologous tissue, the margin of error should be within 10%.

This gentleman had a few failed previous rhinoplasties and finally ended up with upturned tip with nose contraction. At surgery, there was no allplast inside but a long K-wire fixed to the anterior nasal spine supporting the tip was removed. All cartilage grafts removed, recarved, and used as septal extension graft and extended spreader grafts to fix it. Skin was widely undermined to mobilize to the elongated new dome. Conchal composite graft was used to fill the gap between elongated skin and the deficient mucosa on the right side. Even though this is an early postoperative photos, you can recongnize the elongated nose with pushed down nostril margin and columella. Even without using rib cartilage, short upturned nose can be fixed effectively.

https://www.realself.com/find/South-Korea/Seoul/Otolaryngologist/Hong-Ryul-Jin

The lady in below photos visited my clinic for rhinoplasty. She wanted to have more feminine nose instead of her muscline nose. She had a long nose with slight bump on the dorsum, overprojected, slightly bulbous and droopy tip, and slighly wide dorsum.  Surgery was focused on creating more feminine look: hump removal, narrowing the bony dorsum with osteotomies, tip volume reduction, decreasing tip projection, and slight cephalic rotation.  Photos taken 2 weeks after surgery (because she returnd back to her country after surgery) shows changes on the dorsum and the tip. Dorsum became slender with creation of smooth brow-tip aesthetic line. Tip was refined with volume reduction, slight underprojection, and cephalic rotation. Although the changes are not radical, her nose looks more feminine.

Removing nasal filler is often required due to diverse reasons. Acute side effects such as blindness, skin necrosis, infecton are representative reasons. Recurrent skin reaction, nodule or granulation formation, and pressure sense are other reasons for filler removal. Hyaluronic acid filler is easily removed with hyaluronidase injection. Non-resorbable fillers such as auqamid can be squeezed out after making a small incision on the skin, but sometimes it is difficult to completely remove all the fillers injected into the dermis. Trying to attempt all the fillers has the danger of damaging dermis. Sometimes open approach is required when simultanous rhinplasty after filler removal is required. At least a week prior to surgery, absorbable fillers are removed with hyaluronidase injection for accurate shape control in revision rhinoplasty. Fillers at the nasal tip can be removed at the time of open approach and you can often observe inflammation of the soft tissue around the tip. ...

This lady developed short nose after multiple previous rhinoplasties. By using folded temporalis fascia on the dorsum, conchal cartilage onlay graft on the tip, and conchal composite graft on the vestibule, a natural looking nose that has lengthened tip with mildly elevated dorsum.