Bulbous Nose Correction with Rib Cartilage – Case Study in Rhinoplasty Korea

noselab
2025년 4월 5일
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Bulbous nasal tip surgery is a form of structural rhinoplasty that reshapes thick soft tissue and wide lower lateral cartilages to create a narrower, more defined nasal tip while maintaining stable support.

In this case, a patient with a wide nasal tip, nostril asymmetry, and mild bridge deviation underwent a closed structural approach using autologous rib cartilage to restore tip definition, rebalance the nasal base, and achieve a refined contour without external scars.

Author: Dr. Cha-Young Kang, Director, Nose Lab Clinic

Published: April 5, 2025

Hello, this is Dr. Cha-Young Kang from Nose Lab Clinic.

This case study presents a closed rhinoplasty approach designed to structurally refine a wide nasal tip using rib cartilage while preserving natural facial harmony.

Patient Condition and Preoperative Findings

The patient presented with a nasal tip that appeared wide and blunt due to structural and soft tissue factors rather than isolated surface volume.

Frontal, left-side, and oblique view photos taken during design consultation before bulbous nose correction. — Design Consultation: Frontal View, Left Side View, and Oblique Side View Photos

Clinical Assessment

Frontal view: The nasal tip appeared broad with limited definition, accompanied by mild bridge deviation and excessive nostril show.

Profile view: The tip demonstrated a downward tendency with a low radix and a subtle dorsal irregularity.

Nasal base view: The base appeared wide with visible nostril asymmetry and compressed tip support.

Right-side, oblique, and nostril view photos taken during design consultation before bulbous nose correction. — Design Consultation: Right Side View, Oblique Side View, and Nostril View Photos

Surgical Plan – Bulbous Nose Correction with Structural Reinforcement

The surgical strategy focused on internal framework reconstruction rather than surface reduction to achieve a stable and natural outcome.

Key Surgical Principles

Tip framework stabilization: Autologous rib cartilage was used to create durable internal support for controlled projection and shape retention.
Cartilage reshaping: Lower lateral cartilages were repositioned and sutured to narrow the tip without excessive sharpening.
Soft tissue balance: Conservative handling of thick soft tissue preserved circulation while reducing tip bulk.
Base symmetry: Alar base width and nostril alignment were adjusted to correct asymmetry and reduce the appearance of a wide nasal base.

Surgical Results – Structural Changes After Surgery

Postoperative evaluation demonstrated specific anatomical changes rather than general cosmetic improvement.

Frontal view comparison before and immediately after bulbous nose correction surgery. — Before (Left) / Immediately After (Right)

Frontal Comparison

The nasal tip width was reduced, and nostril exposure became more proportionate and symmetrical.

Before (Left) / Immediately After (Right)

Profile Comparison

Tip projection became more stable, and the dorsal contour appeared smoother without creating an artificial slope.

Before and immediately after surgery: Oblique view showing refined nasal contour and better nasal tip definition. — Before (Left) / Immediately After (Right)

Oblique Comparison

The transition from nasal bridge to tip appeared more continuous, with improved definition along the tip complex.

Before and immediately after surgery: Nostril view showing improved symmetry, narrower nasal base, and natural nostril shape. — Before (Left) / Immediately After (Right)

Nasal Base Comparison

Nostril symmetry improved, and the nasal base appeared less broad while maintaining functional airway space.

In structurally wide anatomy, bulbous nose correction is most stable when internal cartilage geometry and support are addressed rather than relying on volume camouflage.

Educational Comparison – Surgical vs Non-Surgical Approaches

Non-surgical methods may temporarily alter contour but do not correct the underlying cartilage structure responsible for a wide nasal tip.

Fillers or threads: Can increase volume and may worsen tip width or asymmetry over time.
Structural rhinoplasty: Allows direct reshaping of cartilage and long-term stabilization of tip form.
Closed approach rationale: Internal access enables precise framework work while avoiding external scars and preserving soft tissue integrity.

This case required a single, definitive structural solution rather than repeated additive treatments.

Immediately after surgery: Frontal, side, and oblique side view showing refined nasal tip, slimmer nasal line, and improved overall symmetry. — Immediately After Surgery: Frontal, Side, and Oblique Side View Photos

Immediately after surgery: Nostril view showing improved symmetry and reshaped nasal base. — Immediately After Surgery: Nostril View Photos

Final Thoughts

This case demonstrates that refinement of a wide nasal tip depends on structural reconstruction rather than simple reduction.A closed rhinoplasty approach using rib cartilage can restore tip definition, improve base balance, and maintain long-term stability when carefully planned.