Crooked Nose Correction and Upturned Nose Revision – A Complex Case in Rhinoplasty Korea

noselab
2024년 10월 26일
3분 분량

최종 수정일: 1월 14일

This case study documents a complex revision rhinoplasty performed to correct severe nasal deviation and an upturned nasal tip following multiple previous surgeries.

Through internal structural reconstruction and vascular-safe technique selection, nasal alignment, tip position, and nostril balance were restored while minimizing the risk of compromised blood supply.

Author: Dr. Cha-Young Kang, Chief Director, NoseLab Clinic

Published: October 26, 2024

Last Updated: January 14, 2026

Hello, this is Dr. Cha-Young Kang, Chief Director of NoseLab Clinic.

This case involves a patient with a long history of nasal procedures who continued to experience deviation, excessive nostril exposure, and instability, requiring a revision strategy focused on safety and internal reconstruction.

Patient’s Concerns and Clinical Background

The patient presented with persistent nasal asymmetry and an abnormally elevated nasal tip despite multiple prior interventions.

Medical and surgical history

Orthognathic surgery (1 year prior)
Nasal filler injections (5–6 years prior)
Rhinoplasty using donated rib cartilage and silicone
Additional rhinoplasty using autologous rib cartilage and silicone
Corrective surgery performed due to risk of tissue necrosis

Clinical observations

Frontal view: excessive nostril exposure and visible deviation
Profile view: elevated tip with high starting point
Nostril view: asymmetry, columellar scarring, and skin depression

Preoperative consultation images showing frontal, left side, and oblique views of a patient with nasal deviation and upturned nasal tip prior to revision rhinoplasty. — Pre-surgery consultation photos: frontal, left side, and oblique views

Pre-surgery consultation photos: right side, oblique side, and nostril views

Surgical Planning – Crooked Nose Correction Using a Closed Approach

The primary surgical concern was compromised blood circulation at the nasal tip due to repeated operations and scar tissue.

For this reason, Crooked Nose Correction was planned using a closed rhinoplasty approach to minimize vascular disruption while allowing full internal reconstruction.

Key surgical objectives

Reconstruct the damaged septal framework with autologous rib cartilage
Lower and stabilize the elevated nasal tip
Realign the deviated nasal bridge
Refine the wide nasal base
Improve lip protrusion and nostril imbalance
Address scar-related skin depression

Surgical Strategy and Intraoperative Considerations

During surgery, signs of limited blood flow were observed, confirming the necessity of avoiding external incisions.

Internal septal reconstruction using rib cartilage provided structural support, while controlled realignment corrected deviation and stabilized tip position without further compromising circulation.

Surgical Outcomes and Structural Recovery

Postoperative evaluation demonstrated clear improvements in nasal balance and stability.

Before-and-after comparison in oblique side view showing improved nasal alignment and stabilized tip position following revision rhinoplasty. — Before surgery (left) / After surgery (right) – oblique side view

Before surgery (left) / After surgery (right) – profile view

Before-and-after frontal view comparison showing improved nasal alignment, reduced asymmetry, and stabilized nasal tip following revision rhinoplasty. — Before surgery (left) / After surgery (right) – frontal view

Before-and-after nostril view showing correction of nostril asymmetry, improved columella alignment, and stabilized nasal base following revision rhinoplasty. — Before surgery (left) / After surgery (right) – nostril view

Observed outcomes

Reduced nostril exposure
Straightened nasal bridge
Natural tip position
Improved nasolabial angle (approximately 95°)
Refined nostril symmetry and columellar scarring

Educational Perspective – Why a Closed Revision Was Necessary

In revision rhinoplasty with vascular risk, technique selection is as critical as structural correction.

A closed approach allows internal reconstruction while preserving soft tissue circulation, making it particularly suitable for patients with extensive surgical histories and scar-related instability.

Final Thoughts

This case illustrates that even high-risk revision rhinoplasty can achieve stable and natural outcomes when surgical planning prioritizes vascular safety and internal structural repair.

Through careful septal reconstruction and controlled realignment, both form and function were restored without increasing the risk of tissue compromise.