Nasal bone osteotomy、Nasal tip shaping 、Rhinoplasty (Skin + Ear Cartilage Transplantation

Left image: Before treatment / Right image: 6 months after

This case involved structural rhinoplasty using both cartilage grafting and osteotomy techniques to achieve improved nasal symmetry and contour. Auricular cartilage was harvested from the left ear (conchal area), and a local flap from behind the ear was used to provide adequate coverage. An open approach was selected, allowing for precise subperichondrial and subperiosteal dissection.

Medial osteotomy was performed using a piezo device (VarioSurg), while lateral osteotomy was conducted manually with an osteotome. To refine the nasal tip, a transdomal suture technique was applied. Additionally, cephalic trimming was performed only on the right lower lateral cartilage to improve definition.

To address asymmetry, the trimmed right alar cartilage was grafted onto the left alar cartilage. For alar rim support and to lower the nostril margin, grafted cartilage was sutured directly to the alar cartilage and securely fixed. The surgical field was thoroughly irrigated before layered closure. Retin™ suture size 10 was used for skin closure.

Swelling, Bruising & Bleeding
Postoperative swelling and bruising around the eyes and nose are common.
Minor bleeding may occur within the first few days.
Infection
Though rare, infections can occur and may require antibiotics or additional treatment.

Asymmetry or Dissatisfaction with Appearance
The final shape may differ slightly from expectations.

Some patients may seek revision surgery for refinement.

Breathing Difficulties
Changes in nasal structure may affect airflow, leading to congestion or difficulty breathing.

Scarring
Open rhinoplasty may leave a small scar on the columella.

Internal scarring or adhesions (synechiae) may also develop and affect the nasal passage.

Septal Perforation
A rare complication where a hole forms in the nasal septum, possibly causing crusting or whistling sounds when breathing.

Numbness or Sensory Changes
Temporary or prolonged numbness in the nose or upper lip due to nerve irritation or damage.

Skin Discoloration or Thickening
Skin on the nose may change color, texture, or thicken, especially after repeated surgeries.

9. Implant-related Complications (if used)
If implants or grafts are used, there may be risk of displacement, infection, or rejection.

10. Need for Revision Surgery
Even with a successful outcome, some patients may require secondary surgery for minor adjustment