How far can nose reconstruction go after removing foreign substances?

Cases of people seeking medical attention due to illegal implants tend to increase over time.

As the nose shape gradually becomes lower and cruder, many visit clinics to change its appearance.

Additionally, there are many who visit due to redness or pain in the nose, indicating an abnormality. These two types of cases can be broadly categorized.

Among cases where the nose shape has become low and crude due to foreign substances,

many tend to consider the surgery to be simple.

They believe that the problem of raising the nose will be solved just like a typical nose surgery,

and thus visit with a simple method in mind.

However, it is important to recognize that approaching such cases with typical nose surgery methods

is very difficult, as there is a possibility of future problems. Therefore, it cannot be approached in the same way as

nose surgery using general implants.

In such cases, after removing the foreign substance, the vacated space is then

filled with the patient's own tissue or cartilage is grafted.

Ironically, however, most people who visit with dissatisfaction about their appearance

feel that there is nothing wrong with them and therefore do not want the removal of the foreign substance that is causing the problem.

They often neglect it until they feel an abnormality in their nose,

and only then seek medical attention, making resolution often difficult.

People who visit due to problems caused by foreign substances often worry that the part where the foreign substance was injected

becomes red, hurts constantly, or that the swelling

fluctuates daily, causing the nose shape to change little by little.

They often do not talk to others about their nose

and try to alleviate symptoms with general drug treatment at other clinics.

However, due to persistent problems, they eventually decide on surgery and visit our clinic.

In such cases, the problematic foreign substance is removed as much as possible, and the tissue is replaced with the patient's own tissue.

When there are problems like this, it is often better to proceed with the surgery in stages,

typically 2-3 times, rather than in a single operation.

Because scars and inflammation caused by the foreign substance are concentrated in the area where it was injected and its surroundings,

when removing the problematic parts in the first surgery,

normal tissue may also have to be removed. Therefore,

in the first surgery, the foreign substance is removed, and the surrounding scar tissue and

inflammatory tissue are preserved as much as possible, followed by another surgery.

The goal of foreign substance removal surgery is to complete it with as few problems as possible,

so it is best to proceed in stages.

After the first surgery, injection therapy and medication to reduce scarring are administered together.

Usually, after the first surgery, we wait until the surrounding tissue settles,

and then consider a second surgery about a year later.

During the second surgery, reconstruction using autologous tissue is performed.

If the foreign substance removal is insufficient when considering the second surgery, foreign substance removal may be performed again.

When removing foreign substances through revision rhinoplasty, inquiries about reconstruction are sometimes made.

Is reconstruction possible after removing foreign substances from the nose with autologous tissue rhinoplasty?

Autologous tissue is free from the hard texture of artificial implants

and is relatively safe from the problem of thinning skin, with a low incidence of inflammation.

It is often more effectively applicable in cases of foreign substance removal due to capsular contracture.

The skin and cartilage tissues that have contracted due to inflammation are carefully separated and dissected sufficiently

to allow them to stretch. After removing the artificial implant, autologous tissues such as septal cartilage,

ear cartilage, or costal cartilage are used to extend the length of the nose without recurrence or deviation,

satisfying the patient's needs and allowing for a safe completion.

For short noses, cases requiring surgery due to injury,

or cases where the skin has become severely thin after foreign substance removal,

using costal cartilage (chest cartilage), autologous dermis, or wrapping with temporalis fascia

during revision rhinoplasty can safely complete the surgery.

What is the most suitable method for revision rhinoplasty to remove foreign substances?

The direction of the surgery, whether open or closed, is determined by the purpose of removing the foreign substance,

the current state of the nose, and the severity of side effects.

Except for severe cases of side effects where all nasal implants and artificial materials used in the first surgery must be removed,

it is possible to proceed with a closed approach.

Occasionally, there is a misunderstanding that revision plastic surgery always involves a wider incision than the first surgery,

leading to a longer recovery period and higher costs. However, even in revision rhinoplasty,

various surgical methods are applied depending on the current state, so it is better to consult with a specialist

rather than worrying alone to find the best method.

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