Hello, this is Dr. Cha-Young Kang, Director of Nose Lab Clinic.
Today, I’d like to share the case of a 28-year-old woman who came to us for closed rhinoplasty to enhance her small nose. Through this case, we’ll discuss key considerations when shaping a smaller nose and achieving natural, balanced results.
1. Patient Information and Pre-Surgical Analysis
Patient Information:
Age: 28, Female
Surgical History: None
Special Consideration: Allergy to certain painkillers
Patient Goals: A longer, higher nose

Pre-Surgical Analysis:
Bulbous and wide nasal tip
Columella retraction
From the side view, the columella was obscured by the alar rim
Protrusive upper lip profile
Irregularities along the nasal bridge
Nostril asymmetry

2. Surgical Plan and Procedure
To achieve the patient’s goals, we created a comprehensive surgical plan:
Septal Extension Graft: Using both septal and donor rib cartilage to support and lengthen the tip.
Tip Refinement: Elevating and slightly projecting the nasal tip while bringing down the columella for balance.
Tip Definition: Suturing the alar cartilage to narrow the wide tip.
Bulbous Tip Correction: Repositioning and suturing the alar cartilage to reduce the appearance of a bulbous tip.
Nasolabial Angle Adjustment: Correcting the nasolabial angle to address the protrusive lip appearance.
Bridge Smoothing: Removing any dorsal hump and placing a silicone implant for a smooth, balanced bridge.
Nostril Symmetry: Adjusting nostril alignment and symmetry through the septal extension and alar cartilage suturing.
Special Precautions: In smaller noses, excess elevation of the nasal tip can risk making it overly pointed or translucent due to limited skin elasticity. We elevated this patient’s tip to around 90% of her skin’s flexibility capacity. To avoid transparency of the cartilage, we reinforced the nasal tip skin with an artificial dermis.
3. Surgical Outcome
The results met the patient’s aesthetic goals:

Before (Left) / Immediately After (Right)

Before (Left) / Immediately After (Right)

Before (Left) / Immediately After (Right)

Before (Left) / Immediately After (Right)
Natural Height: The nose gained natural height and projection, aligning with her request for a longer profile.
Lengthened Tip: The previously short tip was elongated to complement her facial proportions.
Improved Tip Shape: The nasal tip achieved a refined, balanced appearance.
Symmetrical Nostrils: Asymmetrical nostrils were corrected, adding to a harmonious result.
Protrusive Lip Improvement: The nasolabial angle adjustment contributed to a softer, more balanced profile.

Frontal, Side, and Oblique Side Views Immediately After Surgery

Nostril View Immediately After Surgery
This case highlights several crucial points in rhinoplasty. Particularly, it’s essential to know a patient’s medication history and any allergies. For this patient, we carefully selected alternative painkillers and administered preventive injections to avoid allergic reactions during the procedure. In elective surgery, prioritizing safety is paramount.
Additionally, creating a natural look for a small nose requires caution with tip elevation. Overly elevating the tip can lead to issues such as a pointed appearance, cartilage visibility, or redness. Balancing the skin’s size and elasticity with the nose’s projection and structure is key for achieving a natural, lasting result.
Thank you for reading, and please don’t hesitate to leave any questions or comments below. We’re always here to help you achieve beauty and health safely.
Best regards,
Dr. Cha-Young Kang, Director of Nose Lab Clinic


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