A third nose surgery — why it was planned with autologous rib cartilage: a revision case after donor rib cartilage surgery
2025. 1. 24.
A case of someone who had a first surgery with donor rib cartilage·ear cartilage·silicone, then went through reconstructive surgery, and visited again. Organized how a hump irregularity and short-looking nose length were addressed with autologous rib cartilage and osteotomy — plus criteria for judging when silicone looks bent on X-ray.
Key points
- Revision on a nose operated multiple times starts not from new design but from checking what structure and materials remain.
- This case had a first surgery with donor rib cartilage·ear cartilage·silicone and went through reconstructive surgery — for a more stable result, surgery utilizing autologous rib cartilage was planned.
- The dorsum·hump was tidied with osteotomy, and for the bridge rib cartilage particles were utilized instead of the previous implant — considering stability and naturalness together.
"I've already had two revisions — should I do another?"
The more times someone has had nose surgery, the deeper the deliberation before deciding on the next one. Each additional surgery changes the tissue state inside the nose, and the next plan changes depending on what material was used before. This article organizes — centering on the order of judgment and planning — the revision process of someone who had a first surgery with donor rib cartilage, went through reconstructive surgery, and visited again.
01
In what state did they visit again?
The patient in this case had a first nose surgery about 7 years ago using donor rib cartilage, ear cartilage, and silicone, then went through one additional reconstructive surgery — but wasn't satisfied with the result and visited again.
In the previous surgery, hump correction had been insufficient so the dorsum wasn't smooth, and the nose length looking short overall was also confirmed as a concern. The findings from examining the state in consultation were as follows.
- An irregularity in the middle of the dorsum — the cause of the line continuing unnaturally
- Slight nostril asymmetry
- Two prior surgeries — donor rib cartilage had been used in the first
In other words, this wasn't simply a matter of "not liking the line" — the previous surgery's materials and remaining structure had to be checked together. What is checked in a multiply-operated nose can be seen further in the rhinoplasty revision guide.
02
Why was it planned with autologous rib cartilage?
Since there were already two prior surgeries and donor rib cartilage had been used in the first, surgery utilizing autologous rib cartilage was recommended for a more stable result. This approach is considered a comparatively stable choice in high-difficulty female rhinoplasty cases.
The patient wanted a somewhat glamorous impression within naturalness. So the plan was set in two tracks.
| Area | Plan |
|---|---|
| Dorsum·hump | Tidied with osteotomy so the overall line looks sleek |
| Bridge | Rib cartilage particles utilized instead of the previous implant — stability and naturalness considered together |
03
How did the line change after surgery?
After surgery, the dorsum width was reduced in the frontal view, and the tip seen from below was also confirmed tidied in height and shape in the direction the patient wanted. As the tip line became cleaner, the overall impression became neater as well.
After surgery using autologous rib cartilage, the line running from glabella to tip was organized straighter and softer, and the previously sunken-looking center of the dorsum was naturally supplemented. In the side view, improvement of the nasolabial angle (the angle between the nose and upper lip) appeared clearly — one of the important elements in female rhinoplasty.
One point to note is that the bridge can look somewhat high early on — a result designed considering that autologous tissue partially absorbs over time. The appearance shown is about one month post-op; over the next roughly 6 months, absorption and tissue stabilization proceed and the line settles into place. Actual correction cases can be seen in before-and-after photos.
04
Summary — the more surgeries, the more planning comes first
Even when deliberation has deepened through multiple surgeries, a stable result can be expected if the remaining structure and material state are sufficiently checked and a plan is made. This case was a process of re-tidying a nose with donor rib cartilage history using autologous rib cartilage and osteotomy. If you're considering nose revision or nose-line improvement, you can have a plan suited to your current state confirmed in a 1:1 video consultation.
Frequently asked questions
Answers to common questions patients ask before a consultation.
An X-ray showed the nose silicone looking bent — did something go wrong?
Can a nose operated with donor rib cartilage be revised with autologous rib cartilage?
When does the line stabilize after revision?
Responses to treatment and recovery progress vary by individual. Outcomes and side effects vary from person to person. Bleeding, infection, swelling and asymmetry may occur. Please consult our medical team before making a decision.