Closed Rhinoplasty Korea for Columellar Retraction and Alar Deformity

Dr. Chayoung Kang
20분 전
3분 분량

(Revision Rhinoplasty Case)

Columellar retraction and alar deformity after previous rhinoplasty usually result from weakened anterior septal support and distortion of the alar cartilage framework.

In this revision case, autologous rib cartilage was used to reconstruct the anterior septum and right alar cartilage, while functional nasal surgery and paranasal augmentation improved both breathing and facial balance.

This case involves a patient who visited NoseLab Clinic due to columellar retraction and a pinched right alar deformity that developed after previous nasal surgery.

Although the original rhinoplasty had been performed approximately five years earlier, progressive structural change led to columellar depression, right alar cartilage collapse, and nasal obstruction related to rhinitis.

Because both structural deformity and functional breathing problems were present, revision rhinoplasty with comprehensive reconstruction was required.

Preoperative design consultation photos: Frontal view, left oblique side view, and left side view.

Surgical Background – Closed Rhinoplasty Korea

Revision correction of columellar retraction and alar deformity requires restoration of internal support rather than simple surface adjustment.

For this reason, closed rhinoplasty korea was selected to allow internal structural reconstruction, graft replacement, and functional correction without external incisions.

Preoperative design consultation photos: Right side view, right oblique side view, and nostril view.

Structural Problems Identified

Preoperative analysis revealed multiple structural problems caused by the previous surgery:

Columellar retraction due to weakened anterior septal support
Pinched deformity of the right alar cartilage
Nasal obstruction related to septal deviation and rhinitis
Midface depression near the nasolabial folds

The patient also requested replacement of the previous donor rib cartilage with autologous rib cartilage for more reliable long-term support.

Surgical Plan – Structural and Functional Reconstruction

Removal of Previous Implants and Grafts

The first step was removal of materials placed during the prior surgery.

Procedures performed:

Removal of the silicone implant
Removal of the donor rib cartilage graft
Assessment of scar tissue and altered anatomy

This step allowed precise structural reassessment before reconstruction.

Anterior Septal Reconstruction for Columellar Support

The anterior septal cartilage had been weakened and no longer provided stable support for the nasal tip.

Procedures performed:

Reconstruction of the anterior septum using autologous rib cartilage
Restoration of stable tip support
Recovery of natural columellar height

Rebuilding the anterior septum was essential for long-term correction of columellar retraction.

Right Alar Cartilage Reconstruction

The right ala showed a pinched deformity caused by structural loss and asymmetry.

Procedures performed:

Reconstruction of the right alar cartilage using autologous rib cartilage
Additional soft-tissue grafting
Restoration of more symmetrical alar contours

This improved nostril symmetry and created a more natural alar shape.

Paranasal Augmentation

Paranasal augmentation was performed to improve midface balance.

Procedures included:

Implant placement in the paranasal region
Restoration of midface volume near the nasolabial folds
Improvement in the appearance of maxillary protrusion

This contributed to better overall facial harmony.

Surgical Results

Frontal View

The sunken columella was restored
The pinched right ala was corrected
Better nasal symmetry was achieved

Lateral View

Restoration of columellar height improved nasal tip projection
The nasolabial angle became more natural
Midface volume increased after paranasal augmentation

Oblique (45°) View

The nasal contour became smoother
Correction of alar deformity created a cleaner nasal line
Overall facial balance improved

Before and immediately after surgery oblique view showing improved columellar projection and correction of the right alar deformity following revision closed rhinoplasty with autologous rib cartilage reconstruction. — Before Surgery (Left) / Immediately After Surgery (Right)

Nostril View

The previously depressed columella was restored
Right alar cartilage reconstruction improved nostril symmetry
The nasal base appeared more refined and balanced

Surgeon’s Commentary – Why Anterior Septal Reconstruction Matters

Columellar retraction after rhinoplasty is usually caused by loss of stable anterior septal support.

In this case, simply elevating the nasal tip would not have corrected the underlying problem. Reconstruction of the anterior septal framework was required to restore durable support and proper columellar projection.

Autologous rib cartilage was selected because it provides strong, reliable structural stability in revision surgery. The right alar deformity was corrected through cartilage reconstruction and soft-tissue grafting, while simultaneous septoplasty and inferior turbinate reduction improved breathing.

Paranasal augmentation further enhanced facial balance by increasing midface volume and softening the appearance of maxillary protrusion.

Revision rhinoplasty requires detailed analysis of scar tissue, weakened support structures, and altered anatomy from previous procedures. Successful outcomes depend on structure-first planning and individualized reconstruction.