Patient Case Overview – Collapsed Columella Correction After Previous Surgeries

Hello, this is Dr. Cha‑Young Kang, Director of NOSELAB Clinic.

Today, I’d like to introduce a revision rhinoplasty case focused on collapsed columella correction and refinement of a bulbous nasal tip, using autologous rib cartilage for structural support.

🟦 Surgical History & Preoperative Analysis

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

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

📍 Surgical History

• 14 years ago: Hump reduction and tip cartilage suturing

• 12 years ago: Osteotomy, septal cartilage harvest, and alar base reduction

🔎 Initial Assessment

Frontal View

• Deviated nasal dorsum

• Bulbous nasal tip

• Collapsed columella

• Asymmetric nostrils and alar base

Side View

• Drooping nasal tip

• Protruding upper lip

• Sunken columella

Nostril View

• Nostrils asymmetrical due to previous alar base reduction

• Visible scarring on the columella

🟦 Patient's Goals for Collapsed Columella Correction

✨ Patient's Objectives

• Restore collapsed columella structure

• Refine overly bulbous tip

• Achieve a natural, harmonious nose

🟦 Surgical Approach Using Rib Cartilage

💉 Structural Reconstruction

• Septal extension graft with autologous rib cartilage

• Columella reconstruction to restore projection

• Tip reshaping using grafting and repositioning

• Osteotomy to correct dorsal deviation

Aesthetic Refinement

• Improved columella projection

• Refined tip shape

• Enhanced nasolabial angle

• Straighter nasal profile

✅ Surgical Outcome – Collapsed Columella Correction Results

Before Surgery (Left) / Immediately After Surgery (Right)

Frontal View

• Natural nasal refinement

• Symmetry restoration of nostrils

• Straighter nasal dorsum

Before Surgery (Left) / Immediately After Surgery (Right)

Side View

• Better columella support and projection

• Balanced lip-to-nose ratio

• Lifted and defined tip

Before Surgery (Left) / Immediately After Surgery (Right)

Nostril View

• Alar symmetry improved

• Previous scars minimized and blended

Before Surgery (Left) / Immediately After Surgery (Right)

👨‍⚕️ Expert Commentary on Complex Collapsed Columella Correction

Immediately after surgery: Frontal view, side view, and oblique side view photos.

Immediately after surgery: Nostril view photos.

This case required the correction of a collapsed columella and a bulbous tip that were worsened by two previous surgeries.

Our strategy focused on:

• Rebuilding the internal nasal structure using autologous rib cartilage

• Creating a defined but natural tip

• Stabilizing the columella and enhancing nasal aesthetics

Through this approach, we achieved both functional improvement and aesthetically pleasing results.

Thank you for reading.This has been Dr. Cha‑Young Kang from NOSELAB Clinic.

Postoperative precautions and possible complications

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