Droopy Columella and Long Nose Correction with Autologous Rib Cartilage

Dr. Cha-Young Kang | NOSELAB Clinic

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

Today, I’d like to share the case of a patient who presented with a severely drooping columella and long nose appearance—corrected through reconstructive surgery using autologous rib cartilage.

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

📍 Surgical History

2019: Autologous rib cartilage + silicone implant rhinoplasty
2024: Ear cartilage + silicone implant revision

🔎 Initial Evaluation

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

1. Frontal View

Significantly drooping columella
Arrow-shaped nasal tip (over-projected and downward-pointing)
Nostril asymmetry
Pinched alar rim appearance

2. Side View

Drooping nasal tip
Overextended columella
Small nasolabial angle
Protrusive upper lip

3. Nostrils View

Noticeable nostril asymmetry
Deviated columella (tilting right)
Prominent surgical scarring on the columella

✨ Patient’s Concerns

Correct nostril asymmetry
Improve overly long nose
Straighten deviated nose
Achieve a more natural-looking outcome

💉 Surgical Approach

1. Structural Reconstruction

Harvested autologous rib cartilage
Performed septal extension to support columella
Repositioned alar cartilages for symmetry

2. Aesthetic Refinements

Replaced existing dorsal implant
Corrected nasolabial angle
Adjusted high nasal starting point.

3. Results Aimed

Balanced nostrils
Lifted and refined nasal tip
Improved profile, including less protrusive upper lip
Shortened overall nasal appearance

✅ Surgical Results

Before (Left) / Immediately After (Right)

1. Frontal View

Realigned and lifted columella
More balanced nasal shape
Significant improvement in nostril symmetry
Resolved pinched alar appearance

Before (Left) / Immediately After (Right)

2. Side View

Improved nasal tip positioning
Corrected nasolabial angle
Reduced projection of upper lip
Harmonized facial proportions

Before (Left) / Immediately After (Right)

3. Nostrils View

Corrected nostril asymmetry
Straightened columella
Columellar scar now far less noticeable

Before (Left) / Immediately After (Right)

👨‍⚕️ Surgeon’s Insight

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

Immediately After Surgery: Nostril View Photo

This case involved multiple complex challenges including a significantly drooping columella, arrow-like nasal tip, and asymmetrical nostrils. We performed septal extension using autologous rib cartilage to reinforce the internal structure and properly support the nasal tip.

Alar cartilage repositioning allowed us to effectively correct nostril asymmetry, and adjusting the nasolabial angle helped soften the appearance of a protruding upper lip. By subtly lowering the nasal starting point, we were also able to reduce the “long nose” effect.

We paid special attention to the existing surgical scar along the columella, minimizing its visibility through refined contouring. In the end, the patient achieved a more natural, symmetrical, and refined nasal structure, exactly as hoped.

Thank you for reading.

This has been Dr. Cha-Young Kang, Director of NOSELAB Clinic.