Correction of Nostril Asymmetry and Upturned Nose After Alar Reduction โ Autologous Rib Cartilage Revision Case
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Dr. Cha-Young Kang | NOSELAB Clinic
Hello, this is Dr. Cha-Young Kang, Director of NOSELAB Clinic.
Today, Iโd like to share the case of a patient who underwent multiple surgeries, including alar base reduction, and later returned to address nostril asymmetry and an upturned nasal tip through revision surgery using autologous rib cartilage.
Design Consultation: Frontal View, Left Side View, and Oblique Side View Photos
๐ Surgical History
2014: Deviated septum correction + rhinitis surgery + silicone dorsal implant + septal extension (later TP revision)
2015: Nose bridge, tip, and philtrum filler injection (dissolved 3 years later)
2018: Alar base reduction
2021: Philtrum shortening surgery
๐ Initial Evaluation
Design Consultation: Right Oblique Side View, Side View, and Nostril View Photos
1. Frontal View
Bulbous nasal tip
Asymmetric nostrils
Deviated nose
2. Side View
Upturned nasal tip
Prominent upper lip
Irregular nasal dorsum
Hump-like appearance
3. Oblique View
Upturned, bulbous tip
Prominent upper lip
4. Nostrils View
Clear asymmetry due to prior alar reduction
Visible scar tissue at nostril base
โน๏ธ Additional Findings
Preexisting rhinitis
Narrower right nasal cavity
โจ Patientโs Concerns & Goals
Correct drooping alar contour
Smooth out silicone implant step deformity
Straighten the deviated nasal bridge
Improve nostril and alar rim symmetry
Refine the nasolabial angle
Asked about scar revision (not recommended due to risk of worsened scarring with further incisions)
โ Surgical Outcomes
Before (Left) / Immediately After (Right)
1. Frontal View
Straighter nasal alignment
Improved nostril symmetry
More refined and balanced nasal appearance
Before (Left) / Immediately After (Right)
2. Side View
Appropriately lowered nasal tip
Smooth dorsal contour
Reduced prominence of the upper lip
Before (Left) / Immediately After (Right)
3. Nostrils View
Significantly improved nostril balance
Harmonized alar rim contour
Before (Left) / Immediately After (Right)
๐จโโ๏ธ Surgeonโs Insight
Immediately After Surgery: Frontal, Side, and Oblique Side View Photos
Immediately After Surgery: Nostril View Photo
This case involved multiple previous procedures, including alar base reduction and philtrum shortening, which presented both aesthetic and structural challenges. The nostril asymmetry and visible scarring from the alar reduction were particularly important concerns.
While the patient inquired about scar revision, further excision would likely worsen the scarring. Instead, we focused on surgical strategies that would visually soften and balance the existing scar, such as repositioning the nasal tip and improving the alar rim contour.
Using autologous rib cartilage, we were able to reinforce and correct the upturned tip and deviated nose. Replacing the dorsal implant resolved the step-off and enhanced the profile, while also refining the nasolabial angle. The patientโs narrowed right nasal cavity and rhinitis symptoms were taken into account to ensure functional improvements as well.
Thank you for reading.
This has been Dr. Cha-Young Kang, Director of NOSELAB Clinic.
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