Hello, this is Dr. Cha-Young Kang, head surgeon at Nose Lab Clinic.
Today, I would like to introduce a successful rhinoplasty case for a male patient who had concerns about his nose being low, wide, and overshadowed by a prominent brow bone. This case is particularly noteworthy as it involves elevating the nasal starting point (radix) to create a more balanced and natural connection between the forehead and the nose.
Patient’s Surgical History and Requests:
This patient had received nasal filler injections 10 years ago. He requested a natural-looking straight nose (nasal dorsum) that would harmonize well with his facial structure.
1. Pre-Surgery Consultation and Analysis
Pre-Surgery Frontal View, Left Side View, and Oblique Side View Photos
Frontal View:
Low nasal starting point (radix).
Overall wide and low nose.
Noticeable asymmetry in the nostrils and nasal wings.
The philtrum appeared long.
Oblique View:
Prominent brow bone.
Low nasal starting point (radix).
Signs of a protruding upper lip.
Side View:
Low radix and prominent brow bone.
Nose appeared short and small compared to the face.
Drooping nasal tip.
Signs of upper lip protrusion and receding chin (microgenia).
Pre-Surgery Right Oblique Side View, Side View, and Nostril Photos
Nostril View:
Asymmetry in nostrils and nasal wings.
2. Surgical Plan
Considering the patient's nasal condition and aesthetic requests, we developed the following surgical plan:
a) Insertion of a nasal radix silicone implant
b) Septal extension graft using the patient's own rib cartilage
c) Septoplasty
d) Turbinate reduction with radiofrequency laser
e) Repositioning of the alar cartilage and suturing technique for reshaping
f) Removal of existing filler and insertion of a new nasal silicone implant
3. Surgical Procedures
Using a closed rhinoplasty approach, we proceeded with the following:
a) Insertion of a nasal radix implant:
A silicone implant was custom-carved to fit the patient’s brow bone, smoothing the transition from the forehead to the nose. This “starting point elevation” created a natural connection between the brow bone and the nose.
b) Septal extension graft:
Using the patient’s own rib cartilage, we extended the nasal septum to correct the drooping, asymmetry, and widened appearance of the nasal tip.
c) Septoplasty and turbinate reduction:
The deviated septum and enlarged turbinates were treated to improve nasal airflow and alleviate nasal obstruction.
d) Repositioning of alar cartilage and reshaping:
The widened nasal tip was refined, and the nostrils were reshaped to correct asymmetry.
e) Removal of filler and silicone insertion:
The previous nasal filler was surgically removed.
A new silicone implant was inserted to create a smooth, straight nasal dorsum.
4. Before and After Comparison
Before (Left) / After (Right)
Frontal View:
The nose, which previously appeared short and wide, now looks naturally balanced with the rest of the face.
The widened appearance of the nose has been refined.
Nostril asymmetry has been corrected.
The overly exposed nostrils have been minimized.
Before (Left) / After (Right)
Side View:
The protruding brow bone and low nasal radix have been harmonized with a smooth transition.
The previously uneven nasal dorsum has been straightened, creating a sleek and refined line.
Before (Left) / After (Right)
Oblique View:
The overall shape of the nose is much more proportional, with the protruding lips now appearing less pronounced.
The bulbous nasal tip has been refined, creating a more elegant contour.
Before (Left) / After (Right)
Nostril View:
The asymmetry in the nostrils has been greatly improved.
The uneven appearance of the nasal wings has been corrected.
5. Total Review
This case showcases the successful correction of multiple issues such as brow bone protrusion, a low nasal starting point, and a wide nasal structure. The key element in this case was the use of a silicone implant to raise the nasal radix, seamlessly connecting the brow and nasal bridge.
Additionally, the septal extension graft using rib cartilage effectively resolved the nasal tip’s drooping and asymmetry, while also improving the overall structure of the nose. Functional improvements were also achieved with septoplasty and turbinate reduction to enhance nasal airflow.
Another key factor was the refinement of the nasal dorsum by removing the previous filler and inserting a new silicone implant, which smoothed out the nasal bridge and created a more polished appearance.
6. Conclusion
In male patients with prominent brow bones and a low nasal starting point, using the right nasal implant can make a significant difference. In some cases, custom-made 3D-printed implants are considered, but in this case, the angle between the brow and the radix was suitable enough that a custom implant was not necessary.
For men dealing with concerns like a low nose, wide nasal base, or prominent brow bone, I hope this case provides valuable insight. Rhinoplasty isn’t just about enhancing the nose—it’s about achieving facial harmony by considering the relationship between the brow, nose, lips, and chin.
At Nose Lab Clinic, we always take a detailed approach to create the most natural and harmonious result for each patient. If you are considering rhinoplasty, I recommend consulting with a specialist to find the method that best suits your needs.
Thank you for reading this case study. This has been Dr. Cha-Young Kang, head surgeon at Nose Lab Clinic.
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