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Closed rhinoplasty_Korea, Big alar + retracted columella + bulbous nose + wide nose + mild hump nose

This is the patient who visited my clinic because he wanted to correct the big alar and blunt tip of the nose and the sagging nose. I first met the patient in the counseling room, and he had the most memorable big alar nose. Most hospitals would have recommended alar reduction, but the reduction of the alar can make the nostrils small, but our hospital recommends it very carefully because the results are not natural and it is a surgery that cannot be returned to the original state, leaving nostrils asymmetry and lingering scars. However, since the patient is under a lot of stress from the shape of his alar and the appearance of their wide nose, I planned to reduce the base of his nasal floor, not reduce them.

When analyzing the shape of the nose, it was judged that the improvement of the nose's tip point and the retracted columella rather than the alar's shape was more important than anything else.

Surgical findings

The septal cartilage was smaller than expected, and it was located about 5mm deep in the columella, making it difficult to lower the columella. However, using the autologous rib cartilage, a new structure was made in front of the nasal septal cartilage to lower the columella and create a point at the tip of the nose. The nose brigde was flat, so the double eyelid line was set as the starting point, and a silicone implant about 5mm high was placed on the dorsum.

Functional surgery

According to various nose function tests performed before the surgery, the septal cartilage was bent to the right and the both inferior turbinates are hypertrophic states. I planed to do septoturbinoplasty with a high-frequency laser.

A general review

If you look at these phots right after surgery, the columella has come down moderately well, and the appearance of the alar has improved a lot due to the good correction of nasolabial angle. The left nostril is congenitally larger than the right one, but before surgery, it was not noticeable because the nostril was flat, but the shape of the nostril after the operation was good, showing more visibility of the asymmetry, but it is expected to get better over time.

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