Revision Rhinoplasty with Autologous Rib Cartilage for a Bulbous and Long Nose by Dr. Young-moon Yoo of VIBE Plastic Surgery

It is surprisingly common for patients who have already undergone rhinoplasty to say, ‘I still feel like something is missing.’

The patient I am introducing today previously had rhinoplasty using septal cartilage. However, she visited our clinic because her biggest concerns were that the tip of her nose still looked bulbous and the nose appeared long, giving her a heavy and stifling overall impression.

☆ Why was there lingering dissatisfaction even after septal cartilage rhinoplasty?

Septal cartilage is:

✔ Harvested from inside the nose

✔ Associated with relatively low surgical burden

It is an excellent material frequently used in primary rhinoplasty. However, in some cases:

If the amount of cartilage is insufficient, or if the strength is inadequate to firmly support the nasal tip, the tip may not extend as much as desired or may droop and look bulbous again over time.

Particularly in cases of severe bulbous nose or when the tip is long and drooping, a sturdier support structure is required.

☆ The Chosen Solution: Autologous Rib Cartilage Rhinoplasty

For this revision, we proceeded with rhinoplasty using **autologous rib cartilage (the patient’s own rib cartilage)**.

Autologous rib cartilage is:

Available in sufficient quantities and possesses both hardness and elasticity, making it an ideal material to firmly establish the nasal tip structure.

Therefore, in revision cases or when nasal tip correction is critical, autologous rib cartilage offers a significant advantage.

☆ 3 Key Points of This Surgery

1️⃣ Bulbous Nose Correction

If the nasal tip cartilage is spread out, the nose will look bulbous no matter how beautiful the bridge is. Using autologous rib cartilage, we:

✔ Gathered the nasal tip cartilage

✔ Firmly secured the structure

This resulted in a nasal tip that looks slim even from the front.

2️⃣ Nasolabial Angle Correction

The nasolabial angle (the angle between the nose and the lips) is a crucial point that determines the impression of the nose. If this angle is narrow:

The tip looks droopy and the face can appear longer. By stably building the nasal tip support with rib cartilage, we:

✔ Naturally corrected the nasolabial angle

✔ Created a sophisticated side profile without looking overdone.

3️⃣ Correcting the ‘Long Nose’ Impression

Many people worry that ‘my nose looks longer than its actual length.’ In this case, it is not just about shortening the nose, but rather:

✔ Re-establishing the position and angle of the tip

✔ Rebuilding the support structure

Using rib cartilage to stably support the tip, we softly improved the long impression to match the overall facial proportions.

☆ What are the advantages of autologous rib cartilage rhinoplasty?

This is the question patients ask most frequently.

✔ Sufficient Cartilage Volume: Allows for both tip and support structure correction.

✔ Strong Support: Minimal drooping of the tip over time.

✔ Use of Own Tissue: Low concern regarding foreign body sensations or rejection.

✔ Especially Advantageous for Revisions: Can supplement structures that were lacking in previous surgeries.

Therefore, when there were limits to using only septal or ear cartilage, autologous rib cartilage serves as a definitive alternative.

☆ Post-Operative Changes and Satisfaction

After the surgery, the nasal tip looks much more defined, the long impression has been improved, and the overall image has changed to be sharp and sophisticated.

Above all, the patient said, ‘I feel like I finally have the nose shape I wanted,’ making this a very memorable case for me as a surgeon.

☆ I recommend autologous rib cartilage rhinoplasty to those who:

Are dissatisfied even after septal cartilage rhinoplasty

Have a bulbous and drooping nasal tip

Are concerned about a long-looking nose

Require revision surgery

Want a more definitive and stable nasal tip correction

While autologous rib cartilage rhinoplasty is not absolutely necessary for everyone, it is a method that shows a clear difference in results when needed.

Consultations and surgeries should be performed by a board-certified plastic surgeon!

VIBE that comes from rich experience

Dr. Young-moon Yoo, Chief Director of VIBE Plastic Surgery

VIBE Plastic Surgery complies with medical laws. These before-and-after photos were taken under the same conditions with the patient’s consent. Complications and side effects such as bleeding, inflammation, infection, and asymmetry may occur depending on the individual, and caution is required.