This revision rhinoplasty case was very challenging. The patient flew in from Lao PDR to see Dr. Ty (นายแพทย์กิตติศักดิ์ วงค์เทียนชัย, ว.35602) at S45 Clinic because of several complex nose problems, including an infected nose, a collapsed nasal tip and difficulty breathing.

A Challenging Revision Rhinoplasty Case From Lao PDR

For this revision, Dr. Ty used hybrid rib rhinoplasty to correct the problems.

Problems Found in This Revision Rhinoplasty Case

The nose was infected, inflamed, swollen and red after the silicone implant was removed.
The nasal tip had collapsed and contracted upwards, so the nostrils were clearly visible.
The septum was deviated and contracted.
The nostrils were uneven, making it hard to breathe through one side.
The skin of the nose was uneven, sunken in some places, with a lot of scarring.

Steps in This Complex Revision Rhinoplasty

First Revision Operation

Dr. Ty opened the nose to check the problems inside and found that the artificial cartilage used as the septum had pushed through the tissue (because of the infection).
Almost nothing was left of the original alar cartilages that form the nasal structure.
The septum was deviated and pulled by scar tissue, making breathing difficult.
There was pus inside the nose, which had to be treated before the nose could be reshaped.

Second Revision Operation

After the pus inside the nose had been treated and had cleared up, Dr. Ty used open hybrid rib rhinoplasty, because the patient had previously had a silicone implant that pushed through the tip and became infected. The previous materials had also made the skin red, inflamed and infected, and the implant had pushed through the skin. Because of this, the skin had become thinner, so extra care was needed to prevent infection.

How Hybrid Rib Rhinoplasty Was Used

An I-shaped silicone implant was used along the bridge.
Rib cartilage was used to strengthen the nasal structure.
Rib cartilage was used to support the nasal tip so it projects forward.
This lowers the chance of implant extrusion and infection.

After revision rhinoplasty with this technique, the nose has more definition and a longer shape based on the Golden Ratio. The nasal tip is lengthened downwards, where before it was upturned and short. The septum is straight, which makes breathing easier, and the skin of the nose is smoother, with fewer sunken areas and less visible scarring.

How the Patient Feels After Revision Rhinoplasty

“7 days after surgery, when the splint came off and I saw my nose, I cried. I felt like I had been born again, because my nose looked far nicer than I had expected. S45 Clinic and Dr. Ty also told me they will follow up my nose for 5 years, which put my mind at ease.”

Why Choose S45 Clinic for Complex Revision Rhinoplasty?

Complex cases need a lot of experience to correct the different problems. In this case the problems were fairly complex because of several previous revision operations, and S45 Clinic helped the patient regain her confidence and breathe more easily.

Have a Complex Revision Rhinoplasty Problem? Get Advice

See real case reviews

Chat with us on LINE

Message us online

Note: Repeat nose surgery, which many people know as ‘revision rhinoplasty’, is surgery for people who have had nose surgery before and need a further assessment by a surgeon. The approach to care depends on the original problem, the nasal structure and the surgeon’s judgement in each case.