This is the patient who visited my clinic for bulbous and widenose tip and flat and curved nose correction. This surgery was performed with the aim of creating a natural nose shape to match the face ratio. The starting point was planned to hold it between the double eyelids and the pupil line, raise the tip of the nose, and lower the columella slightly to set the nasolabial angle near 90 degrees.
This is a side photo analyzed during preoperative counseling. In order to raise the tip of the nose and bridge overall, I decided to use septal cartilage and rib cartilage at the tip of the nose, and I recommended raising it with a silicone implant on the nose bridge.
The front part had a bulbous and wide feeling, and the facial asymmetry and curved nose were the most prominent. The nose bridge was planned to use osteotomy to improve asymmetry and to give a three-dimensional effect by using bulbous nose correction and nasal floor reduction surgery.
The columella was tilted to the left, and the CT image taken at our clinic showed that the septum was deviated to the left. The nostril was also larger on the left side than on the right side, and there was also an asymmetry of the nose. The plan was made to correct the asymmetry as much as possible and reduce the wide feeling by repositioning the cartilage in the nose and reducing the bottom of the nose.
Looking at the picture right after the surgery, the tip of the nose became pointy, and the columella came down naturally, making the nose look smaller. The nose bridge was raised by about 4mm and became a natural side line overall.
Even in the 45-degree photo, the nasolabial angle was corrected, and the feeling that the mouth seemed to protrude improved a lot, and the tip of the nose that looked blunt became very natural.
In the front, the part that looks curved has improved a lot, the part that looked severely curved at the connection between the nose bridge and the tip of the nose has improved a lot, and the nose bridge has also improved a lot. The bottom of the nose is also naturally narrow.
The asymmetry of the nostrils seems to have improved a lot.
A general review
I had a hard time fixing the tip of his nose because the septal cartilage was bent a lot to the left more than I expected. The first half of the septal cartilage was reinforced strongly with donated rib cartilage, but I think he need to take care not to be exposed to trauma for about six months after surgery.