Case Study: Lateral Osteotomy Correction for Nasal Congestion and Asymmetry – Revision Rhinoplasty Korea

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

Today, I’m sharing the story of a patient who came to us suffering from nasal congestion and asymmetry after an overly aggressive lateral osteotomy performed in a previous surgery. This case highlights the importance of precise lateral osteotomy correction in achieving both functional and aesthetic harmony in revision rhinoplasty.

1. Patient History and Concerns

Surgical History

• 2014: Closed hump nose correction + silicone implant + ear cartilage graft

• 2024: Silicone removal + ear cartilage graft + lateral osteotomy + hump and arrow nose correction

After the second surgery, the patient experienced severe nasal obstruction on the left side due to narrowed nasal passageways.

Patient Requests

• Restore structure compromised by over-aggressive lateral osteotomy

• Address a broad nasal tip and low nasal height

• Correct uneven surfaces and cartilage visibility

• Achieve a natural straight-line contour without implants

• Fix a deviated nose

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

2. Preoperative Assessment

• Asymmetry: Left nasal bone collapse resulting in a deviated, twisted nose

Crooked Nose Caused by Left Nasal Bone Depression

• Tip deformity: Broad, bulbous nasal tip

• Dorsum: Irregular dorsum with residual hump

Residual Hump from Previous Surgery

• Functional issues: Deviated septum, left nasal valve collapse, inferior turbinate hypertrophy confirmed by obstruction tests

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

3. Surgical Plan with Lateral Osteotomy Correction

1. Functional Improvements

• Septoplasty to correct septal deviation

• Radiofrequency turbinate reduction for turbinate hypertrophy

• Left internal nasal valve reconstruction to restore airflow

2. Structural Corrections

• Lateral osteotomy correction: Reposition collapsed left nasal bone and restore symmetry

• Hump correction to smooth residual dorsal irregularities

• Rib cartilage augmentation to elevate dorsal profile without implants

3. Tip Refinement

• Columellar strut graft with rib cartilage for tip support and definition

• Scar tissue removal to smooth subcutaneous layers

• Alar cartilage repositioning and suturing to narrow the nasal tip

4. Surgical Outcomes After Lateral Osteotomy Correction

Front View

• Improved collapsed left nasal bone

• Straightened and symmetrical nose

• Refined nasal tip with balanced proportions

Before (Left) / Immediately After (Right)

Side View

• Natural dorsal height and smooth contour

• Complete correction of residual hump

Before (Left) / Immediately After (Right)

Functional Results

• Restored nasal airflow on the left side

• Resolved obstruction from nasal valve collapse

Before (Left) / Immediately After (Right)

5. Expert Insights on Lateral Osteotomy Correction

Overly aggressive lateral osteotomy can cause not only cosmetic issues but also functional impairment such as nasal valve collapse and severe congestion. Successful lateral osteotomy correction requires a dual approach:

• Structural Restoration: Repositioning and reinforcing nasal bones and cartilage

• Functional Repair: Rebuilding internal nasal valves and maintaining airway patency

This case demonstrates the importance of meticulous planning and precise execution in revision rhinoplasty.

6. Conclusion

Immediately After Surgery: Frontal, Oblique Side, and Side Views

Immediately After Surgery: Nostril View Photos

At Nose Lab Clinic, we prioritize holistic solutions that address both cosmetic goals and functional needs. Complex revision cases such as this show why tailored approaches to lateral osteotomy correction are vital for achieving natural, long-lasting results.

If you are experiencing complications from previous rhinoplasty, we encourage you to consult experienced specialists who understand the nuances of revision surgery.

Thank you for reading. This is Dr. Cha-Young Kang from Nose Lab Clinic.

Nose Lab performs all surgeries using the closed rhinoplasty technique.

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