Hello, this is Dr. Chayoung Kang, Director of Noselab Rhinoplasty Clinic. Today we will introduce the case of a patient who had a bulbous, blunt and droopy nose, as well as a retracted columella. This patient had undergone a nose reduction surgery, and wanted to get a natural but sophisticated nose.
Preoperative Design Consultation
Frontal view
Blunt and wide nose tip
Small and asymmetric nostrils.
Wide nose.
Side profile
Droopy nose tip
Retracted columella that makes the alar more prominent.
Long philtrum and protruding mouth.
45-degree angle
Prominent width of the nose.
Droopy and blunt nose tip.
Nostrils photo
The nostrils had become small due to the previous nostril reduction surgery.
Noticeable nostril asymmetry.
Surgical content
a) Autologous costal cartilage harvesting:
From the 8th rib of the patient’s right side. The incision was around 2.5 cm and we harvested 4 cm approx. of the rib cartilage to perform a septal graft extension surgery in order to lower the columella and correct the nasolabial angle.
b) Septal graft extension surgery:
Reinforcement and extension of the septal cartilage by using the autololgous costal cartilage.
Droopiness correction and heightening the nose tip structure.
c) Bulbous nose correction:
Partial removal of the nose tip subcutaneous tissue. Alar cartilage relocation and tying.
Matching the balance between the contour of the nose tip and the general height increase naturally.
d) Descent and correction of the columella:
Lowering and reinforcing the retracted columella by using the self-rib cartilage, and improving the balance with the alar cartilage.
Achieving an effect to make the philtrum look shorter.
e) Nasolabial angle correction:
Correction of the nasolabial angle using the autologous cartilage to improve the appearance of the protruding mouth.
f) Increasing the height of the bridge and adjusting the starting point.
Removal of the foreign substance (hyaluron filler), and insertion of an implant to lower the starting point.
Every procedure was performed through the closed rhinoplasty approach, without leaving any external scars.
Before and after surgery photos
The blunt and wide nose shape was corrected to look more delicate naturally.
The width of the nose was reduce, and looks overall slimmer.
Improved nostril asymmetry and their visibility remained natural.
Balance improvement as the droopy nose tip was raised.
Harmony improvement between the previously retracted columella and the alar, as the columella was lowered.
Correction of the long philtrum, short starting point and protruding mouth.
The wide nose contour became slimmer.
Enhacement of the three-dimensionality of the nose tip.
Natural-looking straight line nose shaping.
Improvement of the nostrils’ condition while maintaining their size, result from the previous nostril reduction surgery.
The appearance improved as the asymmetry improved.
After surgery table photos
Overview – Retracted columella lowering and bulbous nose rhinoplasty
This case is a complex rhinoplasty case that successfully met the patient’s needs despite the limitations created by the previous rhinoplasty. The overall balance of the nose was improved by lowering the columella, and we were able to achieve harmonious results by simultaneously correcting the nose tip, raising the bridge, and reducing the width of the nose.
In particular, the most difficult part was maintaining the size of the nostrils that had been reduced due to previous rhinoplasty while improving the overall shape of the nose. This was the result of making the most of the advantages of the closed approach and applying intricate surgical techniques.
We successfully constructed the image of the natural, yet sophisticated nose that the patient wanted, and the overall facial balance was improved along with the effect of making the mid-face appear shorter.
I hope this case will provide hope to those who are concerned about a retracted columella, a bulbous nose, or a blunt and droopy nose. Even if you have had previous surgery or have complex problems, you can still achieve satisfactory results with proper surgical planning and techniques.
Noselab Rhinoplasty Clinic always provides the most optimized surgical plan for each patient based on the latest medical technology and abundant experience. Those who are considering rhinoplasty should consult with a specialist to find the method that is best for them.
With Noselab Clinic you can achieve a beautiful and healthy nose!
Thank you,
Noselab Rhinoplasty Clinic
Dr. Chayoung Kang.
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