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Closed rhinoplasty_Korea Deviated nose + upturned nose + retracted colummela + asymmetric nostrils revision case(self-rib cartilage)

When the patient visited my clinic, the shape of the nose looked long and high, but she wanted the tip of the nose to be as high as possible. She said she wanted the tip of the nose to be pointed more than now, so I planned surgery to raise it as high as possible without being seen the cartilage on the tip of the nose.

I took this picture when I designed it before surgery. I planned to raise the tip of her nose that looks drooping to the front, improve the feeling of showing a lot of nostrils from the front, and lower the starting point to the pupil line so that her nose does not look long. The columella is retracted, so I decided to lower the columella and correct the nasolabial angle 95 degrees.

The cause of nostril asymmetry was estimated to be the unreasonably asymmetrical alar reduction in the previous surgery clinic, and the asymmetry worsened as the tip of the nose tilted to the left. The asymmetric correction surgery was planned to move the tip of the nose to the right and tie and reposition the alar cartilages.

The nostrils were seen a lot in front of the patient, and the starting point was high, so the impression was strong and the tip of the nose was curved to the left. The patient thought that the tip of her nose was blunt and wanted to make the tip of her nose more high and thin, so I planned to reconstruct the septal cartilage using her own rib cartilage and raise the tip of his nose as safely as possible.

If you look at the photos taken immediately after the surgery, the tip of the nose has risen enough and the nasolabial angle has been naturally corrected to about 95 degrees, you can see that the starting point of the brow is lowered to the pupil line. The contour of the tip of the nose, which seemed blunt, has become very clear.

It’s a 45-degree side photo. You can see that the nostrils have been corrected a lot and the protruding mouth has improved a lot.

The tip of the nose, which was upturned, came down naturally, and the feeling of bending to the left has improved a lot. The spread between the eyebrows of the nose has also become much more natural.

The nostrils asymmetry caused by the alar reduction and the bending of the tip of the nose, which had been excessively performed in previous clinic, can also be seen to have been greatly corrected by improving the curvature of the tip of the nose and repostioning the cartilage in the nostrils. The feeling that the tip of the nose was wide has also changed to a very thin feeling. It can be seen that the area where the columella appeared to have fallen to the left has improved a lot through the reconstruction of the severely damaged septal cartilage.

A general review

At the time of the patient’s visit, she had a high and long nose, but she asked me to make it higher and pointed, so I decided to do my best not to overdo it and went into surgery. According to the surgical findings, the nasal tip was not very good, so it was found that the nose tip was bent to the left and spread out, and the septal cartilage was reconstructed using self-rib cartilage, and the nose tip was raised from a safe state to the highest point. Alloderm (artificial dermis) was implanted at the tip of the nose to prevent the skin from becoming much thinner, although it looks a little spread out, and it is expected that the tip of the nose will become thinner and more natural after recovery.

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