Dorsal Hump Revision Rhinoplasty with Nostril Correction
- Dr. Chayoung Kang
- 2025년 5월 12일
- 5분 분량
This case reviews dorsal hump revision rhinoplasty in a patient with residual dorsal hump, excessive nostril exposure, broad and flat nasal bridge, deviated nasal axis, drooping nasal tip, sharp nasolabial angle, elongated philtrum appearance, nostril asymmetry, columella deviation, and previous filler history after primary nasal surgery 17 years earlier. Surgery focused on autologous rib cartilage septal extension, filler material removal, dorsal hump refinement, lateral osteotomy, nasal tip repositioning, nostril exposure correction, nasolabial angle refinement, and closed rhinoplasty structural correction.
Author: Dr. Cha-Young Kang
Clinic: NoseLab Clinic
Published: 2025
Last Updated: 2026
Introduction
Hello, this is Dr. Cha-Young Kang of NoseLab Clinic.
This case involves dorsal hump revision rhinoplasty in a patient who had undergone primary nasal surgery 17 years earlier and later presented with residual dorsal hump, nostril exposure, and nasal asymmetry.
The patient also had a history of filler injection approximately 10 years earlier. Because the case involved previous surgery, filler material, nasal deviation, and nostril exposure, the surgical plan required both structural correction and soft tissue evaluation.
The surgery was performed using a closed rhinoplasty / endonasal approach. The goal was to refine the dorsal hump, correct nasal deviation, reposition the nasal tip downward to reduce nostril exposure, improve the nasolabial angle, and support the nasal framework with autologous rib cartilage.
Patient Case Overview
The patient visited NoseLab Clinic for revision rhinoplasty because the dorsal hump and nostril exposure remained visible long after previous nasal surgery.
The patient wanted a balanced nasal shape that improved nostril exposure without excessive height or overly dramatic projection.
Main Concerns
The main concerns included:
Residual dorsal hump
Excessive nostril exposure from the frontal view
Broad and flat nasal bridge
Deviated nasal axis
Drooping nasal tip
Sharp nasolabial angle
Elongated philtrum appearance
Nostril asymmetry
Rightward columella deviation
Previous filler injection history
These findings suggested that simple hump removal alone would not be enough. Nasal bridge alignment, tip position, nostril exposure, filler material, and facial balance needed to be evaluated together.
Preoperative Analysis
Preoperative design consultation photos were reviewed from the frontal, side, oblique, and nostril views.
Frontal View
The frontal view showed a broad and flat nasal bridge, deviated nasal axis, and excessive nostril exposure.
The visible nostril exposure was related to nasal tip position, columella alignment, and lower nasal support.
Side View
The side view showed a drooping nasal tip, residual dorsal hump, sharp nasolabial angle, and elongated philtrum appearance.
Because the side profile involved both the bridge and the tip, dorsal correction and tip repositioning needed to be planned together.
Nostril View
The nostril view showed nostril asymmetry and a columella leaning to the right.
This lower nasal imbalance was considered during septal extension and tip repositioning.
Patient Goals for Revision Rhinoplasty
The patient wanted to reduce visible nostril exposure and improve the dorsal contour while keeping the overall change balanced.
Main Goals
The goals included:
Reduce visible nostril exposure from the frontal view
Refine the residual dorsal hump
Improve nasal bridge symmetry
Improve projection without excessive height
Correct the deviated columella and nostril asymmetry
Improve the sharp nasolabial angle
Create a balanced nasal shape in harmony with facial features
The plan was designed to avoid excessive projection while improving support and balance.
Surgical Plan for Dorsal Hump Revision Rhinoplasty
The surgical plan included structural correction, filler removal, dorsal hump refinement, nasal deviation correction, tip repositioning, and nostril exposure correction.
Autologous Rib Cartilage Septal Extension
Autologous rib cartilage was used for septal extension.
This helped support the nasal tip and allowed controlled repositioning of the tip to reduce excessive nostril exposure.
Filler Material Removal
Previously injected filler material was removed where it was identified.
In revision rhinoplasty after filler injection, the amount of removable material may vary depending on filler location, tissue integration, scar tissue, and surrounding anatomy.
Nasolabial Angle Refinement
The nasolabial angle was refined by adjusting nasal tip position and columella support.
This helped improve the relationship between the nasal tip, columella, upper lip, and philtrum.
Lateral Osteotomy
Lateral osteotomy was performed to improve nasal deviation and correct the nasal axis.
This step also helped refine the broad nasal bridge and improve midline alignment.
Dorsal Hump Refinement
The residual dorsal hump was carefully refined to create a smoother dorsal contour.
Because this was a revision case, the previous surgical changes and tissue condition were considered during hump correction.
Nasal Tip Repositioning
The nasal tip was repositioned downward to reduce nostril exposure from the frontal view.
This step was planned conservatively to avoid excessive lengthening or an unnatural appearance.
Surgical Results After Revision Rhinoplasty
Frontal View
From the frontal view, the nasal bridge appeared more aligned after osteotomy and structural correction.
Visible nostril exposure was reduced after nasal tip repositioning and septal extension.
Side View
From the side view, the dorsal line appeared smoother after dorsal hump refinement.
The nasal tip projection appeared more balanced, and the nasolabial angle improved after tip and columella support.
The philtrum appeared visually shorter in proportion after nasal tip repositioning and nasolabial angle correction.
Nostril View
From the nostril view, nostril symmetry improved, and the columella appeared more aligned.
The nostril shape appeared more balanced after septal extension and lower nasal correction.
Structural Outcome
The dorsal hump, nasal deviation, nostril exposure, sharp nasolabial angle, nostril asymmetry, and columella deviation were corrected together.
Because this case involved previous surgery and filler history, the outcome was planned within the limits of scar tissue, filler distribution, cartilage support, skin condition, and healing response.
Surgeon’s Commentary
Revision rhinoplasty for a recurring or residual dorsal hump should not be planned as hump removal alone when nostril exposure, tip position, and nasal deviation are also present.
In this case, the patient had previously undergone hump removal 17 years earlier and filler injection 10 years earlier. These previous treatments were considered during surgical planning.
Autologous rib cartilage was used for septal extension to support and reposition the nasal tip. This was important for reducing frontal nostril exposure while maintaining a balanced side profile.
Filler material was removed where identified, and lateral osteotomy was performed to improve nasal axis alignment.
Dorsal hump refinement, tip repositioning, nostril correction, and nasolabial angle adjustment were planned together because the patient’s concerns involved both the bridge and lower nasal structure.
This case shows that dorsal hump revision rhinoplasty may require combined correction of the nasal bridge, tip support, nostril exposure, filler-related tissue changes, and facial balance.
FAQ
What is dorsal hump revision rhinoplasty?
Dorsal hump revision rhinoplasty is revision nasal surgery performed when a dorsal hump remains, recurs, or appears irregular after previous rhinoplasty. It may involve hump refinement, osteotomy, tip support, and contour correction.
Why can nostril exposure remain after previous rhinoplasty?
Nostril exposure may remain or worsen when the nasal tip is over-rotated, under-supported, shortened, or positioned too high. Columella position and nostril asymmetry can also contribute.
Why is rib cartilage used in this type of revision rhinoplasty?
Rib cartilage may be used when stronger structural support is needed for septal extension, tip repositioning, or revision framework support, especially when previous surgery has changed the original cartilage structure.
Can filler be removed during revision rhinoplasty?
Filler material may be removed when it is identified during surgery. The extent of removal depends on filler type, location, tissue integration, scar tissue, and surrounding anatomy.
Can dorsal hump correction and nostril exposure correction be done together?
Yes. When the dorsal hump and nostril exposure are both present, bridge contour, nasal tip position, columella support, and nostril symmetry should be evaluated together.
International Consultation
For international patients, a photo-based consultation may help clarify whether dorsal hump revision rhinoplasty, nostril exposure correction, rib cartilage septal extension, filler removal, osteotomy, or tip repositioning may be needed.
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