Closed Rhinoplasty Korea for Septal Loss and Upturned Tip

Dr. Chayoung Kang
1시간 전
3분 분량

(Revision Rhinoplasty Case)

Loss of the anterior septum leads to severe nasal tip instability, over-rotation, and alar deformities.

In this case, complete septal reconstruction using rib cartilage restored nasal support, corrected an upturned tip, and improved both nasal symmetry and breathing through a closed rhinoplasty approach.

Author: Dr. Cha-Young Kang, Director, NoseLab Clinic

This case involves a revision rhinoplasty patient presenting with severe structural deformities following previous surgeries, including complete loss of the anterior septum, an excessively upturned nasal tip, and bilateral pinched alar deformities.

The patient had undergone two prior rhinoplasty procedures using silicone implants and cartilage grafts. During previous surgery, the anterior septum had been removed and used as graft material, resulting in loss of the primary support structure of the nasal tip.

As a result, the patient developed significant tip over-rotation, nostril overexposure, alar collapse, and dissatisfaction with both nasal appearance and function.

In this case, structural correction was achieved through closed rhinoplasty korea, focusing on reconstruction of the internal framework rather than superficial correction.

Preoperative design consultation photos showing upturned nasal tip, pinched alar deformity, and nasal asymmetry from frontal, left oblique, and left lateral views. — Preoperative design consultation photos: Frontal view, left oblique side view, and left side view.

Surgical Background – Closed Rhinoplasty Korea

Revision rhinoplasty involving septal loss requires complete reconstruction of the internal nasal framework.

For this reason, closed rhinoplasty korea was selected to allow precise structural rebuilding while minimizing additional external tissue trauma and avoiding external incisions.

Preoperative design consultation photos showing over-rotated nasal tip, pinched alae, and nostril overexposure from right lateral, right oblique, and basal views. — Preoperative design consultation photos: Right side view, right oblique side view, and nostril view.

Structural Problems Identified

Preoperative evaluation revealed critical structural deficiencies:

Complete loss of the anterior septum
Excessive nasal tip over-rotation
Nostril overexposure
Bilateral pinched alar deformities
Depressed dorsal contour
Compromised nasal airflow

These issues required full structural reconstruction rather than partial correction.

Surgical Plan – Comprehensive Structural Reconstruction

Anterior Septal Reconstruction with Rib Cartilage

The absence of the anterior septum required full reconstruction.

Procedures performed:

Reconstruction of the septum using autologous rib cartilage
Restoration of central nasal support
Stabilization of nasal tip position

This step was essential to correct tip over-rotation and restore long-term stability.

Nasal Tip Support Restoration

The nasal tip lacked structural support and was excessively rotated.

Procedures performed:

Reinforcement of nasal tip support using rib cartilage
Controlled repositioning of the nasal tip
Reduction of nostril exposure

Alar Cartilage Reconstruction

The patient presented with bilateral pinched alar deformities.

Procedures performed:

Reconstruction of alar cartilages using rib cartilage grafts
Restoration of natural alar curvature
Improvement of nostril symmetry

Dorsal Contour Correction

The nasal dorsum showed areas of depression.

Procedures performed:

Application of crushed rib cartilage
Smoothing of dorsal contour
Creation of a natural nasal bridge line

Functional Nasal Surgery

Functional correction was necessary to improve airflow.

Procedures included:

Septoplasty for internal alignment
Inferior turbinate reduction to relieve obstruction

These procedures improved breathing and nasal function.

Surgical Results

Frontal View

Reduction of nostril overexposure
Improved nasal symmetry
Correction of alar deformities

Lateral View

Upturned nasal tip repositioned to a natural angle
Stable nasal tip support restored
Smooth dorsal contour achieved

Oblique (45°) View

Harmonious nasal contour
Improved structural balance

Before and immediately after surgery oblique view showing correction of upturned nasal tip, improved alar contour, and reduced nostril show following revision closed rhinoplasty with rib cartilage reconstruction. — Before Surgery (Left) / Immediately After Surgery (Right)

Functional Outcome

Improved nasal airflow
Enhanced breathing comfort
Stabilized internal nasal framework

Before and immediately after surgery basal view showing reduced nostril show and improved alar symmetry following revision closed rhinoplasty with rib cartilage reconstruction. — Before Surgery (Left) / Immediately After Surgery (Right)

Surgeon’s Commentary – Managing Septal Loss in Revision Rhinoplasty

Complete loss of the anterior septum represents one of the most challenging conditions in revision rhinoplasty.

Without septal support, the nasal tip becomes unstable, often resulting in over-rotation, nostril overexposure, and alar collapse.

In this case, autologous rib cartilage was used to reconstruct the septum and restore a stable central framework. This allowed correction of the nasal tip position and provided long-term structural durability.

Pinched alar deformities were corrected through cartilage reconstruction, restoring natural curvature and symmetry. Crushed rib cartilage was used to address dorsal irregularities, allowing smooth contouring without excessive rigidity.

Revision rhinoplasty involving septal loss requires advanced surgical planning due to scar tissue, weakened structures, and limited native cartilage. A structure-first approach is essential to achieve both functional improvement and natural aesthetic outcomes.