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Excessive Nostril Reduction Reconstruction – Case Study of Structural and Functional Restoration

Hello, I’m Dr. Cha-Young Kang, Director of Nose Lab Clinic.


This case highlights the challenges and solutions in reconstructive rhinoplasty following excessive nostril reduction. The patient had undergone multiple rhinoplasties, including aggressive alar reduction, resulting in scarring, asymmetry, and functional obstruction.


Patient’s Surgical History

  • 10 years ago: Bulbous tip correction, ear cartilage graft, silicone implant

  • 6 years ago: Ear cartilage graft, silicone replacement, septal cartilage graft

  • 3 years ago: Donor rib cartilage graft, silicone replacement, excessive nostril reduction surgery

  • Additional: Nasal obstruction surgery


Preoperative design consultation photos showing frontal view, left side profile, and left oblique 45-degree angle before nostril reconstruction surgery (closed rhinoplasty)
Design Consultation: Frontal View, Left Side View, and Oblique Side View Photos
Original image ↗

Key Symptoms and Patient Requests

  • Severe nasal obstruction (worse on the left)

  • Lower nasal starting point

  • Balanced, natural-looking nose (not elongated)

  • Soft nasal tip with refined contours

  • Straight dorsum and improved symmetry

  • Lower columella for corrected nasolabial angle

Preoperative design consultation photos showing right side profile, right oblique 45-degree angle, and nostril view before nostril reconstruction surgery (closed rhinoplasty)
Design Consultation: Right Side View, Oblique Side View, and Nostril View Photos
Original image ↗

Preoperative Analysis

Frontal View:

  • Blunt, undefined nasal tip

  • Crooked nose

  • Indistinct nasal contour

  • Overall unnatural appearance

Side Profile:

  • No visible columella

  • Droopy tip with poor projection

Oblique View:

  • Irregular implant outline

  • Blunt, heavy nasal tip

Nostril View:

  • Severe scarring from previous nostril reduction

  • Asymmetrical, contracted nostrils

  • Deviated columella


Surgical Plan and Procedures

Structural Reconstruction:

  • Rib cartilage graft for septal extension and framework support

  • Reconstruction of alar cartilages

Aesthetic Refinement:

  • Lowering the columella for an improved nasolabial angle

  • Removal of scar and excess soft tissue

  • Tip refinement for natural definition

Functional Improvement:

  • Septal deviation correction

  • Turbinate reduction surgery to improve nasal airflow


Postoperative Results

Before and immediately after frontal view of nostril reconstruction following excessive nostril reduction with rib cartilage graft and closed rhinoplasty
Before (Left) / Immediately After (Right)
Original image ↗

Frontal View:

  • Sharper, defined tip

  • Balanced, symmetrical nostrils

Before and immediately after side profile view of nostril reconstruction following excessive nostril reduction with rib cartilage graft and closed rhinoplasty
Before (Left) / Immediately After (Right)
Original image ↗

Side Profile:

  • Lowered nasal starting point

  • Improved tip projection and columella positioning

Before and immediately after 45-degree oblique view of nostril reconstruction following excessive nostril reduction with rib cartilage graft and closed rhinoplasty
Before (Left) / Immediately After (Right)
Original image ↗

Oblique View:

  • Straight dorsum with smooth profile

  • Harmonized facial proportions

Before and immediately after nostril view of reconstruction following excessive nostril reduction with rib cartilage graft and closed rhinoplasty, showing improved symmetry
Before (Left) / Immediately After (Right)
Original image ↗

Nostril View:

  • Improved symmetry

  • Stabilized columella


Specialist Insight

Immediately after surgery photos of nostril reconstruction following excessive nostril reduction – frontal view, side profile, and 45-degree oblique angle with rib cartilage graft and closed rhinoplasty
Immediately After Surgery: Frontal, Side, and Oblique Side View Photos
Original image ↗
Immediately after nostril reconstruction surgery – base view showing nostril asymmetry correction with rib cartilage graft in closed rhinoplasty
Immediately After Surgery: Nostril View Photos
Original image ↗


Excessive nostril reduction leaves permanent, high-risk changes. Overcorrection causes irreversible scarring and contraction, making reconstruction technically challenging.

Key insights:

  • Always avoid aggressive nostril reduction.

  • For bulbous tips, nostril reduction should be a last resort.

  • Conservative approaches prevent long-term complications.

At Nose Lab Clinic, our goal is to restore both structure and function, while achieving the most natural balance possible. Prevention remains the best strategy, but when complications arise, advanced reconstructive techniques can deliver stable, satisfying results.


Nose Lab performs all procedures via closed rhinoplasty.

Postoperative precautions and possible complications after rhinoplasty – includes information on infection, bleeding, asymmetry, allergic reactions, and scarring.
Case photograph 9
Original image ↗




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