I’ve had nose surgery several times. Know what you’re doing before you get surgery

These are my personal thoughts after spending a year visiting around 70 clinics and hearing opinions from many doctors. There are many surgical materials these days, such as costal cartilage, septal cartilage, ear cartilage, dermis, AlloDerm, Medpor, and so on. In the 1970s and 1980s, before the Korean plastic surgery society had really taken shape, some doctors used costal cartilage or septal cartilage to build up the nose. Then from around 1990, surgeries were done with simple silicone L-shaped implants only (from the bridge all the way to the tip). In the late 1990s and early 2000s, a new material called Gore-Tex appeared. In 2005, there was a boom in rhinoplasty using costal cartilage. Has anyone had rhinoplasty for 10 years without problems? I know a few people like that around me too. Did those people have tip projection or columellar support surgery using materials like costal cartilage, ear cartilage, septal cartilage, Medpor, and so on? Most people who had surgery earlier had simple procedures with a single piece of straight silicone (silicone), or straight silicone connected in one piece with ear cartilage / L-shaped silicone (bridge / tip / support). Costal cartilage? It has only been used in cosmetic surgery for a little over 6 to 7 years. In 2008, rumors started circulating that costal cartilage was the best material for cosmetic plastic surgery. That kind of nonsense. Costal cartilage can warp... and it is hard. It is also difficult to remove (with a risk of significant tissue damage). Lip correction, cat-eye surgery... some crazy doctors were trying to use it just to make money. There are even famous hospitals specializing in costal cartilage. That hospital seems to have an amazing advertising effect. Costal cartilage is something to consider only in the most aggressive cases, when the nose has collapsed, the septum is gone, the nasal bone is gone, or there is contracture, and things have gone all the way to the extreme. With costal cartilage, you can raise or lower the nasal tip too. In other words, it means pulling the columella upward with the force of the costal cartilage, or forcing it downward. When reconstruction is needed, or when there is no ear cartilage or septal cartilage left, it is cartilage used as a last-resort substitute. There are more than a few people whose lives were ruined after having unnecessary costal cartilage used in their first surgery. It should absolutely not be used for cosmetic purposes. It is hard to remove, and there is no answer later. If it holds up for 5 years or 10 years, you are really lucky. Some truly conscientious doctors have said that using this surgery for cosmetic purposes is crazy. Septal cartilage alone is useful for lengthening the tip, projecting the tip, and providing support. It is less burdensome than costal cartilage, and it is easier to harvest. Septal cartilage can be used for lengthening, projection, and support. The amount of material needed is that large. If you remove the septum, you can run into deviated septum, rhinitis, and functional problems, and things can go badly. Septal cartilage should only be used in situations like this. Patients with a deviated septum, meaning only a small amount should be removed for treatment. Rhinoplasty should be done using only the small amount of septal cartilage that is unnecessary. Or in Black noses / for nasal lengthening. If there are no functional problems, but septal cartilage is used to manipulate the tip and other parts of the nose, right now you may be able to place silicone on top and keep the tip propped up with the septum, so the outside shape does not collapse, but inside, it is often already collapsing. For those people, if it is removed later, there can be a hollowed-out middle and complete disaster. Over time, the nose gradually sags. The bridge sinks too. If someone says, “Let’s do a simple surgery with ear cartilage and silicone,” and you think that doctor has no skill and is using an old-fashioned method, that is absolutely not the case. Just because surgery uses many materials such as septal cartilage, costal cartilage, Medpor, or AlloDerm does not mean it is automatically better. The material is not the important thing. A nose done with ear cartilage. A nose done with costal cartilage. Any doctor can probably shape well with costal cartilage, right? If you operate with good materials, anyone can shape it easily. Real skill is a doctor who performs surgery as safely as possible with the minimum necessary materials, without forcing things. Some so-called masters of rhinoplasty can bring down everything with ear cartilage. They can bring down a turned-up nose. A truly skilled doctor uses nothing inserted, but instead works with silicone or dermis / alar cartilage repositioning / tip structural change / ear cartilage. They operate with skill, not with good materials. Especially for a fleshy nose, costal cartilage should absolutely not be used. You should not insert anything if possible (alar cartilage repositioning / changing the tip cartilage structure /) If you want more height, use ear cartilage / if it is too lifted, dermis / alar reduction That is the best surgery for a fleshy nose. Every person has limits to their nasal condition. If you force surgery aggressively beyond that limit, problems will happen 100% of the time. You just have to live within your own limits as you are. No matter how much plastic surgery has advanced in our country, a nose that is beyond repair can never be made safely into a doll-like nose. If you use costal cartilage, septal cartilage, and Medpor, maybe it is possible, but problems will arise within 5 years. Do you want a doll-like nose for 5 years and then, after 5 years, a nose that is worse than before surgery, a ruined nose? That is reality. If it is a nose with decent conditions, you could make it into a doll-like nose with a silicone bridge / dermis, ear cartilage / alar cartilage repositioning / a small amount of septal cartilage. When having nose surgery, never touch the septum unless it is deviated septum or Black nose. Unless it is a collapsed nose or a destroyed nose requiring reconstruction, costal cartilage should not be used for cosmetic purposes. You should have surgery using safe methods such as ear cartilage / dermis / AlloDerm / tip cartilage repositioning / structural modification, and a method that does not go beyond your own limits. Cosmetic surgery using Medpor / costal cartilage / septal cartilage? That is something you need to think carefully about. Nose surgery will at some point cause a problem once or twice. If you use costal cartilage from the beginning, there is no backup plan. If you used septal cartilage from the beginning, most doctors would say to use costal cartilage afterward.