Rhinoplasty Korea KIES-U Plastic surgery

The doctors are mostly worried about the inflammation and bending in a nose surgery (especially cosmetic surgery).
Why do these complications (inflammation, bending, changing, twisting) exist? I would like to share about this today.

How is the Physiological match?

The first problem is that the foreign substances enter the body and restrict normal circulation.
The nose is a part of the body, and all the parts of the body has blood circulating with supply of nutrition and oxygen, and removing of body waste.
If there is no such circulation in any part of the body, then the body becomes weak to

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Implant / Body waste, other waste, carbon dioxide / Oxygen, nutrition, immune system
It’s like having a upper pipe and a lower pipe, but there is something stuck in between. Although there is water circulation, the circulation is slowed down by the substance that is stuck. What happens to the water that does not flow down the basin? The basin would turn dirty and mold can be formed. If you use the water and let it flow down, this would not happen.

Rhinoplasty Korea KIES-U

As the implant gets bigger or thicker, such delay in circulation becomes worse. This would lead to damage in supply of nutrition and in removing waste. Finally such happening would cause weakened immune system and higher possibility to infection.
The usage of implant does not always lead to infection. There are other variables as well. The more important issue would be how well the implant physiologically matches the surrounding skin tissue in a nose surgery.

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The implant should not make a dead space between the bone below and the skin tissue on top of it. It should structurally fit into the body. Also, there should be minimum bleeding in the desquamated skin around the implant. If there is much damage and bleeding, then there would be much capsular formed making the implant move to another position. The implant would not fit properly with the surrounding skin tissue. If the surrounding tissue remains undamaged and functional, there would be no problem caused. However, if the skin tissue is pushed, pressed down, or if there is a deal space, then the skin tissue cannot remain healthy and functional.

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This physiological match of the implant with the nose is the life or death matter. The same applies to the cartilage, skin, or fat transplant as well.

Nose surgery can be thought of as three dimensional example of a building being remodeled. You cannot change the foundation such as the electricity, water pipe, and others in order to change the shape of the building. Changing the foundation would lead to side effects. The most representative side effect would be infection and bending of the nose.

There is a possibility of hindrance in circulation due to the usage of the implant.
If the surrounding tissue of the implant is not healthy, then there is a breakage in the physiological match.

These two situations would be the source or the cause of infection on the nose after the surgery.

If you are already infected, 

Not all infection, including that from microorganism, lead to symptoms. Most infections have more sleeping effects underneath such as that of an iceberg. If the infection causes itching, edema, fever, oppressive pain, then there is something much larger under the iceberg.


If there is clinical symptom that pops up and disappears often, this means that the iceberg is rising then going down repeatedly. It’s not that the iceberg is getting smaller and larger again.


All the infection or the bending of the nose caused with the movement of the implant are caused by the physiological mismatch of the foreign substance and the original nose skin tissue. The treatment to this would be returning to the original state.

If the implant is the problem, then it should be removed or changed. If the implant is pressurizing the cartilage or the skin then there should be changes made in order for it to be physiologically matching with the nose.

If the outcome of the first surgery leads to severe damage to the skin tissue and inability of the nose resisting the changes, then the implant should be completely removed without any hesitation.

It is best to go back to the original state and hope for the better future, then to leave it as it is.


Today, we looked at the core issue in structural nose surgery. A good nose surgery would lead to good physiological balance between the nose and the implant used.

There would not be any infection / bending / twisting of the nose, and the skin would not change form also.

Thank you for reading. Have a great day.

Structural nose surgery – Short nose (upturned nose, piggy nose) correction

Correcting a short nose can be looked at as a very important nose surgery.
Many Koreans do this and there are many inflammation, contracture, and other problems in the first surgery therefore there are much needed solution to eh short nose in the re-surgeries.


Short nose can also be called a upturned nose or a piggy nose. It refers to the short distance between the nasion and the nose tip, but each person has different face length so there is no absolute standard. One can call a short nose is the ratio of the length of the nose is short compared to the height. Also, a distinction of the short nose is that the nose has sharp edge on philtrum-nose pillar.


Short nose correction involves primary and secondary surgeries that have different methodology and interest.
The primary surgery involves normal short nose surgery. The most common method is lengthening transplant between the cartilage (nasal septum cartilage is mostly used)



The distance between the cartilages needs to be longer so that the cartilage on top and bottom can be turned around. This involves ‘pushing’ transplantation (ear cartilage is used).
These are the two methods.


The secondary is similar in methodology but the nose is contracted.
The reaction towards the outer substance leads to severe scar tissue that contracts the nose leading to a short nose.

The desquamation of such scar tissue and contraction is mandatory in the secondary surgery. A good desquamation then is followed up by extension transplant and/or pushing transplant.

Extending the cartilage is important however, the skin must be extended as well. In order to do so, a splint is used.
Today, I posted on the nose surgery. Short nose, upturned nose, piggy nose correction. Thank you for reading. Have a good evening.

Application of structural nose surgery (diced cartilage)

I explained on the overall concept of the structural nose surgery last time. Today, I would like to share on how the structural nose surgery can be applied to different noses.
When conducting a structural nose surgery, one needs to consider physiological status of the nose, the harmless effect on the skin tissue, and minimized damage on the skin and the tissue.
Let’s compare the nose to a building. When you construct a building, the priority is to build it safely therefore the groundwork foundation of the building should be strong and you also should use the right materials so that the building stays up for a long time.

If you want just a fancy building and do not focus on the basics or the fundamentals, then this could lead to an accident.
Let’s say you want to fix the 매부리코. You want to have this done quick then one would need to grind the nose then place the implant on top with cartilage or derma at the nose tip.


One must use the patient’s skin or tissue in structural nose surgery.
If you took off the cartilage or the bone from the hump, then this should be diced and used to make the nose tip or the nasion higher.
If you need more cartilage, then the cartilage and the dermal grind from the ear can be used and applied on the necessary part. This would help avoid any confusion in the blood circulation or the thinning of the nose skin that could make the inner side visible.


Using the structural graft (cartilage, dermal) to make the nose ridge higher
Also, you may think that the nose is very much like the original one.
There are many perceptions on the nose surgery including a negative one. The first reason for this is the silicone implants is too widely used. If it is easy to make out that you had a nose surgery then this means that people who look at you might not all have a positive perception on you.

There are times when the implant is necessary (for ex: when you need large amount of your own skin tissue, but you cannot find more), however, if you aren’t in such a situation, you should try not to use the implant.

We use the diced cartilage because it has longer durability than the lump of cartilage and also because we do not want the cartilage to damage the skin or surrounding tissue.

Easier explanation can be provide with the image of kimbab below.




There are many methods that can be applied on the nose surgery and there are many new methods that are tried today as well. However, the biggest principle does not change.

The principle that the surgery should be structurally safe and the safe environment should be maintained. The physiological balance on the nose should be maintained. These are the principles.

Thank you for reading. Have a great day.

Dermal fat graft rhinoplasty – Structural nose surgery

Today, I would like to look into the most important part of structural nose surgery, dermal fat graft.

First rule of structural nose surgery is to minimize any physiological damage on the original tissue.

Second is to use as much human tissue as possible.

It is common to manipulate the cartilage and transplant it for the nose tip, and the cartilage is applicable for the nose pillar but using the dermal makes the whole process easier.

Rhinoplasty Korea KIES-U plastic surgery

The first part of the dermal fat graft is to find a spot to collect the dermal fat. At times the fat behind the ear is use. if the side of the nose need to be reduced then, this fat is used also.

If we collect the dermal fat from the buttocks, then the scar can be hidden, and much fat can be gained therefore this is widely applicable.

Rhinoplasty Korea KIES-U plastic surgery

Rhinoplasty Korea KIES-U plastic surgery

The incision and the desquamation for the nose surgery are the same as any other usual plastic surgery.

Rhinoplasty Korea KIES-U plastic surgery

At times, this dermal fat is used for better effect on paranasal augmentation or nasolabial fold. Using one’s own fat instead of implant is better in terms of safety and minimizing side effects therefore this is widely used.

Rhinoplasty Korea KIES-U plastic surgery

In comparison with implant, dermal fat needs to be collected from one’s own body and therefore the disadvantages are that it takes more time and the tissue might disassemble or be absorbed.

If the implant is used, complications such as unnatural look, calcification, infection-inflammation can be avoided. Another advantage is that implant is applicable for damaged or bent nose therefore there is cosmetic and regenerating effect as well.

Today, I posted on the dermal fat transplant with various images. Thank you for reading.
Have a great day.

Idea behind structural nose surgery:

Nose surgery does not only mean that you can make the nose higher or longer.
One must know the structure and anatomical situation of the nose and change accordingly in order to result in long maintenance of the new nose without any side effects.

This is the most important point of the structural nose surgery.




The most concerning part about the nose surgery is that many are worried about the nose looking ‘fake’. Also many are worried that things may go wrong somehow.

If you want to avoid the feeling that your nose is fake, or want to avoid any future problems such as inflammation or contraction (nose becoming smaller), then there is one very reliable method.

Do not damage your original nose structure. Just use the skin for the surgery.


About silicone:  
It is true that the silicone most instantly and quickly makes the nose shape into what the patient wants. The price is relatively cheap and it is easy to make into the shape necessary. If you design it properly with clear lines and shape, there would be good results after the surgery.

But the problems rise few years after the surgery.
However, this does not happen to all the patients.
Many patients suffer change, contraction, inflammation, etc after a few years.
Reconstruction is even worse.

Silicone does not mix with the body therefore thick walls are formed around the implant.
We call this capsule. If the capsule does not cause any problem, then it is fine. However, this is not always the case.
If there is a severe case of capsule on one side only, then the implant would change its location. The implant moves to the weaker side and with time, the nose changes shape as well.


If there is a capsular contracture, the tissue at the tip of the nose gets pulled in and the nose becomes shorter.
If there are some substances around the silicone, these substances do not dissolve and stay around leading to inflammation and infection.
These are some problems of using silicone implant.

If the implant stays in the body for a long time, the cover tissue or skin that surrounds the implant suffers resistance from the implant and becomes thinner.



The skin tends to age and the skin tissue suffers difficulty in blood circulation becoming thinner. In the long run, you will be able to see the two end margin of the silicone that is shaped as “11” (margin visibility).



Therefore, it is more effective to use your own skin tissue for the reconstruction in the nose surgery.
The goal of nose surgery that everyone wants:
No fake looking nose,
Avoiding horrendous side effects
Can be achieved when taking your skin tissue and improving the body through anatomical and structural approach. This is what we call structural nose surgery.


Some methods of structural nose surgery: 

If you divide the nose at large, there would be a case where the bone is low (root of the nose ~ nasal ridge) and where the cartilage is low (nasal ridge ~ nose tip). Most Koreans have both these problems as they want the nose surgery.

 I would like to share an example of a good method on how the surgery can be conducted.

The shape and the height of the nose tip is controlled by using ear cartilage or the nasal septum cartilage.

Artificial skin, artificial bone, and donated cartilage all have their limitations and there are concerns of inflammation, the all these can be sucked in and stuck out.
There are many different methods but the simplest one is to use the ear cartilage and put it on top of the nose wing cartilage.

If you are a patient with thick skin and need to put the nose up high, then we use the nasal septum cartilage and place it on top of the nose wing cartilage making the nose tip stronger.

Nose surgery requires using own cartilage to come up with the best possible result.
Second method is to use anything to place it on top of the nose root ~ nose ridge area. The doctors are often tempted to use silicone or gore-tex implant.

However, this is not a structural surgery but a structure destroying surgery. I think that it is best to limit the usage of implants when possible (unless it is definitely necessary).
If you put silicone or Gore-Tex, it would push down the structure making it difficult for you to breath and might end up with some unexpected results in the long term.

It could be a good idea to use polyamide and liquid formed aqua filling filler or hydroxyapatite for the first nose surgery. The surgery time would be extremely short and if you do not like the result, we can correct it or even melt the substance.
This would be mostly impossible to do for the reconstruction.

One can use the fat between the buttocks and thigh to make the nose root ~ nose ridge part higher.
The nose skin that has become thin due to the silicone and the lower part of the nose bone after the removal of the silicone would not look good for the nose shape.

But using the silicone again to fill up this space will make the nose thinner and hollowed out.
If you use your own thick skin, you can supplement on the skin loss and also reduce the concern of the bone hollowing.
If the nose is severely changed in share, costal cartilage is used for the reconstruction surgery.

Structural nose surgery is not hurting the face structure or the nose organization but positively improving the looks. This approach would lead to best long term results and also reduce the possibility of reconstruction surgery.

Let’s summarize the structural nose surgery algorithm.





Thank you very much.


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