VIP International Plastic Surgery Center in KOREA - Revision Rhinoplasty

Before & After / Revision rhinoplasty
Contracted nose deformity due to injection
Side Effects of Foreign Material

When a foreign implant such as silicone is placed in the nasal tip, the skin gets thinner, so the side effect appears.
Ear cartilage also shows side effects when placed in the nasal tip.
Therefore, when the structural cartilage, which establishes the structure of the nasal tip, becomes longer and larger, the nose can appear natural. Such newly conceptualized procedure is called the autologous tissue rhinoplasty.

Flushed Nasal Tip

The silicone inserted into the end of the nasal tip irritates the skin, resulting in redness, and the skin presses the silicone whereby the silicone shows.
Therefore, the nasal tip must be constructed by the autologous cartilage, so as to minimize the problems and appear natural.

Twisted nose, Bent nose

When the inserted silicone is bent inside the nose, it is because the septal cartilage inside the nose was originally deviated and could not support the structure of the nose. If the silicone is inserted without the revision of bent structure, asymmetry will occur based on the bent shape.

Therefore, it is important to identify whether septal deviation exists when planning for rhinoplasty. If the nasal septum is deviated, it is necessary to first revise the bent nasal septum to set up a stable nose structure and then augment the nose.

Before & After / Revision rhinoplasty
Protruded mouth due to mid-face retrusion
Nose with Silicone Line

The silicone inserted to the nose tip shows the deformity; it is different from the original nose shape. As the nasal tip is established by the silicone, the skin gets flushed.

The newly conceptualized autologous tissue plastic surgery prevents such obvious appearance and creates a natural looking nose.

Stubby nose

Using AlloDerm without structural change of the nose tip or just using the cartilage despite its wideness may result in a stubby nose without a two-pointed peak. Therefore, to make a beautiful nose tip, the skin must be thin and the shape of the structural cartilage must be small and protrusive.
Thus, a structural nose surgery using autologous tissue is necessary.

Upturned nose

When the contraction occurs due to the implant, the nose becomes severely turned up and the nostrils are more visible. In serious cases, it is necessary to first ensure the length and the structure, and then the height using autologous tissue.

Before & After / Revision rhinoplasty
Short nose revision with midface augmentation
Droopy nose

Generally, droopy nose cannot be improved by inserting silicon on the bridge and the tip, because the cartilage that supports the nose tip is weak and already tilted to the front.
It is necessary to support the front of the nose tip with autologous tissue to elevate the droopy tip.

Asymmetric Nostrils

The septal cartilage centered inside the nose plays an important role in making the nostrils symmetrical.
In case of nasal septal deviation or bent septum due to a trauma, it is necessary to improve the nasal septal deviation prior to the nose augmentation procedure.

Protruded mouth due to mid-face retrusion

Many Asians have a dented alar base, narrow nasolabial angle, and mouth protrusion. For such people, just augmenting the nose bridge without the improvement of depressed area and narrowing the nasolabial angle makes the nose appear unnatural, which causes frequent revision surgeries. Therefore, for protruded mouth with nasolabial angle, it is necessary to support a strong structure and then widen the nasolabial angle with VIP’s Noble Surgery.

In addition, when elevating the nose tip, the mouth looks retruded and the chin looks smaller, resulting in a more natural looking face.

Columella retruded nose

Columella is the part that supports in between the nostrils. If the septal cartilage is short, the columella looks retruded. Therefore, it is necessary to graft the cartilage in between the nasolabial angle in order to bring the retruded columella out.

Right-angled nose

The ideal angle from the columella to the nasal tip is not 90°, but 30°- 45°. This can occur when the silicone or the cartilage is placed forward in a short nose.
Deformation due to inflammation

When there’s infection on the implant such as silicone or Gore-Tex, contraction will occur and the nose will deform. The shorter the nose is and more serious the deformation is more autologous tissue is used to rebuild the nose structure.

Injection side effects

When silicone is injected in to the face including the nose, in long term, the skin gets flushed and tumor grows abnormally and skin necrosis can occur if serious. Removing illegal injection is the most difficult matter to treat.

In this case, the treatment removes the left over injection and tumor and then uses autologous tissue to make the structure of the nose with augmentation.

Before & After / Revision rhinoplasty
Silicone protrusion on the tip
Reasons for Increase in Revision Surgery
Rhinoplasty has been popular since the 60-70’s. It is the most wanted plastic surgery after eyelid surgery. In the beginning, non-qualified and non-medical specialists performed silicone injection, paraffin or Vaseline, which destroyed the nasal tissue and developed granuloma.
These symptoms usually occur after several years, which increased the number of revision surgeries.
Another main reason that silicone has been commonly used for rhinoplasty is since the 1980’s, implants such as silicone were inserted to the end of the nasal tip. Implant insertion often results in inflammation, outer protrusion, distortion and skin thinness.
All these problems become noticeable as time goes by, which led to the increase in revision surgery.
Recently, “AlloDerm” is used for nasal tip surgery in many cases. However, human skin is not strong enough to resist AlloDerm, and cannot make any form while maintaining the structure. Therefore, there are numerous cases that require revision surgery since the nasal tip became bulbous by using AlloDerm to augment the nose. However, AlloDerm is good for the purpose of thickening the skin.
There are many cases in Asian nose that the structure is not built well with odd ratio and angle. Also, the structure itself is very weak in many cases.
In such condition, the existing procedure prefers only to insert implant on the flat structure rather than setting up the right structure or strengthening the weak structure. This procedure conceals the deformed part rather than improving it. Because of this passive method (camouflage method), even after the procedure, the structural problem still remains.
Also because of passive treatment, contraction (scarring inside the nose) occurs and structure gets deformed. Therefore, previous passive surgeries lead to constant revision surgeries.

To evaluate the shape of the nose after the surgery, it requires certain period since the tissue needs to be mature over time.
It is common for patients to decide hastily on revision surgery and thus result in problems.