Closed Bulbous Tip Correction in Korea: Filler Residue Removal via Alar Cartilage Trimming

Hello, this is Dr. Cha-Young Kang, Medical Director of Nose Lab Clinic.

Today, I'd like to share a case of closed bulbous tip correction in Korea, where we addressed a bulbous nasal tip and nasal asymmetry caused by residual HA filler that had not fully dissolved, along with nasal obstruction. This case highlights the importance of both aesthetic refinement and functional restoration through alar cartilage trimming and precise surgical planning.

🔎 closed bulbous tip correction in Korea

Design Consultation: Frontal View, Left Side View, and Oblique Side View Photos

Functional Concerns

• Nasal obstruction and difficulty breathing

Aesthetic Concerns

• Deviated nasal axis

• Bulbous tip due to enlarged alar cartilages

• Residual HA filler from 5 years ago that had not fully absorbed

• Broad nasal appearance from prominent alar cartilage

Design Consultation: Right Oblique Side View, Side View, and Nostril View Photos

✨ Patient Goals

• Improved breathing

• Correction of nasal deviation

• Reduction in nasal width and bulbous tip size

💉 Surgical Procedures

Foreign Material Removal

• Complete excision of undissolved HA filler

• Removal of any residual injection materials

Structural Enhancements

• Septorhinoplasty using autologous rib cartilage

• Correction of nasal deviation via lateral osteotomy

• Alar cartilage trimming to refine the bulbous tip

Functional Restoration

• Septoplasty and submucosal turbinate reduction using radiofrequency to relieve nasal obstruction

✅ Surgical Results

https://video.wixstatic.com/video/256f0f_003b1bb5e2724d3f811709d765521494/1080p/mp4/file.mp4

Postoperative video showing the nasal shape and movement immediately after closed bulbous tip correction.

Functional Outcomes

• Restored nasal airflow

• Resolution of chronic nasal congestion

Before (Left) / Immediately After (Right)

Frontal View

• Symmetrical nose with refined contour

• Narrowed nasal base and tip refinement

• Corrected nasal deviation

Before (Left) / Immediately After (Right)

Lateral View

• Harmonized nasal profile

• Naturally contoured tip and nasal bridge

Before (Left) / Immediately After (Right)

Alar View

• Proportional and aesthetically pleasing alar size

• Refined, balanced nasal tip

Before (Left) / Immediately After (Right)

👨‍⚕️ Specialist Commentary

lmmediately After Surgery: Frontal, Side, and Oblique Side View Photos

Immediately After Surgery: Nostril View Photo

This case involved complex aesthetic and functional issues stemming from a series of non-surgical and surgical interventions. The patient had received HA filler injections five years prior, followed by an attempt to dissolve the filler a year ago. However, residual filler remained embedded in the tissue, creating asymmetry and fullness in the tip.

While HA fillers are typically reabsorbed over 6 to 12 months, factors such as injection depth, product type, and individual tissue response can result in prolonged presence or encapsulation. In this case, surgical removal was necessary to fully resolve the issue.

Additionally, the patient had undergone a questionable procedure involving an injection intended to "melt" fat or cartilage in the alar region. This unverified method can be harmful and may damage vital nasal structures, highlighting the need for evidence-based treatment.

The patient’s primary concern was a bulbous, wide nasal tip. Intraoperatively, we observed significantly enlarged alar cartilages. We performed precise trimming to reduce nasal width while maintaining natural contours. This type of cartilage reshaping demands meticulous technique to avoid collapse or unnatural appearance.

To address breathing issues, we concurrently performed septoplasty and turbinate reduction. These interventions alleviated obstruction and improved nasal function.

Ultimately, we successfully removed residual filler, corrected the deviated nose, and refined the bulbous tip with targeted cartilage trimming. The result is a balanced, elegant nasal contour that aligns with the patient’s expectations both functionally and aesthetically.

Thank you,Dr. Cha-Young KangMedical Director, Nose Lab Clinic

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