Correcting a Deviated and Drooping Nose – Crooked Nose Correction Using Rib Cartilage

[Nose Lab Clinic]

Hello, this is Dr. Cha-Young Kang, Director of Nose Lab Clinic.

Today, I’m sharing a complex case involving crooked nose correction through revision rhinoplasty using autologous rib cartilage. The patient had undergone multiple previous surgeries, which left her with noticeable deviation and a drooping nasal tip that significantly affected both function and facial balance.

Design Consultation: Frontal View, Left Side View, and Oblique Side View Photos

Case Background – The Need for Crooked Nose Correction

The patient presented with:

• A visibly deviated nasal structure

• A bulky, undefined, and drooping nasal tip

• Excessive nostril exposure

• A narrow nasolabial angle

• History of rib cartilage grafting, septal cartilage use, silicone implant, and fillers

These concerns required a strategic surgical plan centered on restoring symmetry and supporting the nasal tip for long-term balance.

Design Consultation: Right Side View, Oblique Side View, and Nostril View Photos

Patient History and Primary Concerns

Past Surgeries:

• 5 years ago: rib cartilage + septal cartilage + silicone + hump reduction

• Additional nasal filler history (removed during revision)

Primary Complaints:

• Noticeable deviation from the frontal view

• Downward-pointing, drooping nasal tip

• Poor nostril symmetry

• Weak nasal tip support

Surgical Goals and Planning for Crooked Nose Correction

• Straighten the deviated bony-cartilaginous structure

• Correct the drooping nasal tip and enhance definition

• Lift and support the tip to improve the nasolabial angle

• Achieve more symmetrical and natural nostril exposure

Preoperative Planning Included:

• Facial asymmetry evaluation

• Removal of residual filler

• Rib cartilage preparation for stable grafting

Surgical Techniques – Rib Cartilage Reconstruction and Tip Refinement

• Lateral osteotomy to straighten the bony pyramid

• Autologous rib cartilage graft to rebuild and support the nasal tip

• Septal extension grafting to stabilize projection and direction

• Nasolabial angle correction to restore proportion

• Tip refinement and reshaping for natural aesthetics

• Nostril base realignment for symmetry

Postoperative Results – Symmetry, Function, and Proportion

Before (Left) / Immediately After (Right)

Frontal View:

• Straightened nose aligned with the facial midline

• Balanced nostril exposure and width

Before (Left) / Immediately After (Right)

Side View:

• Elevated and supported nasal tip

• Smooth, natural dorsal line

• Improved nasolabial angle and facial proportions

Before (Left) / Immediately After (Right)

Overall:

• Strong nasal structure

• Natural definition

• Long-term functional stability

Before (Left) / Immediately After (Right)

Expert Commentary – Key Challenges in Crooked Nose Cases

1️⃣ Persistent deviation: required careful osteotomy and structural balancing

2️⃣ Tip ptosis with poor support: addressed with rib cartilage grafting

3️⃣ Residual filler: necessitated complete removal to ensure graft integration

✅ Crooked nose correction demands a deep understanding of 3D nasal anatomy, precise surgical execution, and long-term tissue stability through autologous materials.

Final Thoughts – Achieving Natural Balance Through Crooked Nose Correction

Immediately After Surgery: Frontal, Side, and Oblique Side View Photos

Immediately After Surgery: Nostril View Photos

This case reflects how crooked nose correction, especially in revision rhinoplasty, requires more than just reshaping—it demands restoration.Through rib cartilage reconstruction and tailored adjustments, the patient achieved:

• A naturally straight, centered nose

• A defined, lifted nasal tip

• Harmonious facial proportions and improved nasal function

At Nose Lab Clinic, all rhinoplasty procedures are performed using the closed (endonasal) approach.

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