Hello! I am Dr. Chayoung Kang, the director of Noselab Clinic.
Today we will talk about a patient who got nose filler 14 years ago, and then had the filler removed at another hospital, as well as a rhinoplasty using ear and septal cartilage. However, the nose was still long, so the patient visited our hospital.
This patient had also undergone a double-jaw surgery, so I thought that the septal cartilage would have weakened a lot.
Preoperative consultation
When I first met the patient in the treatment room, I remember that the glabella looked tall and the nose look long. From the front, looked overall blunt and wide, as well as long, which made the patient look older than they were.
From the side profile view, the nose tip looked long, and droopy, and the mouth also appear protruding. The nasolabial angle was small, and the parts along the nose tip, philtrum and lips did not have a natural-looking appearance.
In the nostril photos, it is noticeable that there is a difference in the size of the nostrils and asymmetry, and we can judge that the nose had widened after the double-jaw surgery.
Surgery Plan
That is why I thought that I must focus on making the septal cartilage stronger. I predicted that the long and droopy lookinng shape of the nose was a sign that the septal cartilage had become weak after the double-jaw surgery. That is why I planned to reconstruct the septal cartilage by using the self-rib cartilage.
Overall, the appearance and shape of the nose having filler was very strong, The patient said that in the records it said the filler had been removed during the previous surgery, but that maybe there was still a considerable amount remaining, so I thought that removing the filler in this surgery was an important part.
I supposed that the blunt appearance of the nose tip was due to a lot of scar tissue appearing, so I planned to remove part of the subcutaneous tissue to reduce the thickness of the skin.
I planned to removed the foreign substance from the nose bridge, and use a silicone implant to heighten the bridge.
Before and After surgery photos
From the side profile, we can see that the starting point of the nose bridge has been lowered significantly, and that the shape of the nasolabial angle has improved a lot. The blunt appearance of the nose tip has also improved.
In the 45-degree angle view, we can see that the nose tip has become slimmer.
The nose that looked overall blunt and deviated has now improved a lot. Since we removed the foreign substance, there are somee bruises which make the nasal dorsum look red at the moment, but it is expected to heal right away.
The nostril asymmetry improved a lot.
Seeing the shape of the nostrils, the right nostril that looked severely asymmetrical has now been made more similar in shape, reducing the difference.
Photos after the surgery
Relationship between the double-jaw surgery and rhinoplasty
Today I will discuss about the relationship between facial contour surgery and rhinoplasty. The facial contour surgery that can affect rhinoplasty is the double-jaw surgery. Double-jaw surgery is a surgery that separates the upper jaw bone and the lower jaw bone and fixes it again. However, the part where the upper jaw bone is separated from the facial skeleton is the lower part of the septal cartilage. Therefore, by undergoing double-jaw surgery, the septal cartilage may get damaged or weaker. That is why double-jaw surgery affects the method to perform rhinoplasty in the case of a septal extension graft.
First of all, since the septal cartilage is weak, it is hard to harvest the septal cartilage as material for rhinoplasty, so it may be necessary to use a strong material such as the self-rib cartilage or donated rib cartilage.
Secondly, in the case that the forward part of the septal cartilage is weak, if we make a septal extension graft, problems such as the nose tip make becoming bent or drooping may occur. That is why we must make a septal cartilage reconstruction, and make the cartilage stronger to prevent the nose shape from deforming.
Today we talked about a patient that had undergone a double-jaw surgery and rhinoplasty. I hope this text is helpful for those who have had a double-jaw surgery and are considering to get a rhinoplasty.
Dr. Chayoung Kang
Director of Noselab Clinic
Comments