The nasal manifestations of the Wegener’s granulomatosis commonly results in destruction of the
cartilaginous support of the nose and a severe saddle nose deformity. It is so difficult to correct the
saddle nose deformity because surgeons have fear about relapse of the Wegener’s granulomatosis
and cannot use the septal cartilage as a donor site. However we reconstructed the deformity with
chondro-osseous rib graft successfully. A 49-year-old woman had a saddle nose deformity after
resecting Wagener’s granulomatosis, and suffered from not only aesthetic problem but also dyspnea
and nasal airway obstruction while physical exercise. She underwent a rhinoplasty with rib graft. The
correction came out to be successful and the nasal airway complaint was resolved. She had a
recurrence of Wegener’s granulomatosis at postoperative 6 months and was admitted for medical
treatment of the inflammation at the nasal septum. The follow-up computed tomographic image study
revealed good maintenance of the graft. Saddle nose deformity that arises from Wagener’s
granulomatosis should be reconstructed with chondro-osseous rib graft. Even though the disease
might recur, influence to the grafted cartilage is minimal. Active treatment with plastic surgery is
thought to be no problem for reconstruction. (J Korean Soc Aesthetic Plast Surg 17: 47, 2011)