Long Nose Correction After Multiple Non-Prosthetic Rhinoplasties | Closed Rhinoplasty Korea

noselab
2024년 8월 19일
3분 분량

최종 수정일: 9월 30일

Hello, this is Dr. Chayoung Kang, Director of Noselab Rhinoplasty Clinic.

Today, we will introduce a case of long nose correction in a patient with a droopy tip and high nasal bridge starting point.

This patient had undergone several non-prosthetic rhinoplasties over the past 11 years, and this was her 5th revision.

Preoperative Design Consultation for Long Nose Correction

Patient’s surgical history:

11 years ago – Nose filler
10 years ago – Nasal hump osteotomy using septal cartilage (closed rhinoplasty, no implant)
Year 2020 – Osteotomy and bulbous nose correction surgery using ear cartilage and donated rib cartilage (open rhinoplasty, no implant)
Year 2020 (6 months later) – Corrective rhinoplasty to improve pinched appearance of the nose (no implant)
Year 2022 – Nostril lowering surgery using donated rib cartilage (no implant)

rontal view before long nose correction rhinoplasty, showing nasal deviation and wide nose tip. — Frontal view

Wide and blunt nose tip
Visible nasal deviation

Side profile

Long nose
Droopy nose tip
High glabella starting point
Noticeable depression in the scar area of the columella, product of the previous open surgery.

45-degree angle view before long nose correction rhinoplasty, showing bulbous long nose with masculine appearance. — 45-degree angle view

Blunt, long and bulbous nose
Masculine and older appearance overall

ostril view before long nose correction rhinoplasty, showing nostril asymmetry and tilted columella — Nostril view

Bluntness
Noticeable nostril asymmetry

Surgical plan

Taking into account the patient’s condition and needs, we established the following surgical plan:

a) Removal of foreign body from the nose bridge

b) Reducing the width of the nose through lateral osteotomy

c) Lowering the starting point by shaving the nasal bone and inserting a silicone implant

d) Correction of the nose tip using donated rib cartilage

e) Septoplasty

f) Submucosal resection of inferior turbinate using high-frequency laser

Before and After Surgery Photos

Frontal view before surgery (left), After surgery (right)

The wide and blunt nose improved to look more slim and sophisticated.
Correction of the deviated nose.
More harmonious appearance overall.

Side profile before surgery (left), After surgery (right)

Adjustment of the lenght of the nose.
Improvement of the droopy nose, elevating it harmoniously.
Natural-looking lowering of the glabella starting point.
Correction of the depressed area in the middle of the columella.

45-degree angle before surgery (left), After surgery (right)

Improved the bulbous nose appearance.
The nose shape became smoother and natural-looking.

Nostrils before surgery (left), After surgery (right)

Improvement of the nose into a more sophisticated shape.
Great improvement of the nostril asymmetry.

After surgery table photos

Photos taken immediately after surgery, frontal view, side profile, and 45-angle view.

Overview – Non-prosthetic revision rhinoplasties

This case is a good example of the problems that can occur after multiple no-implant rhinoplasty surgeries. In no-implant surgeries, the bridge of the nose often becomes uneven due to the material used to fill the nose bridge, and in order to smoothly correct this, the previously transplanted tissue must be completely removed. This process is a very delicate and difficult task, and requires extensive experience in foreign body removal surgeries.

In this patient’s case in particular, the structure of the nose was complicated due to multiple no-implant surgeries. If the nasal bone is shaved multiple times, the nasal bone may become blunter, wider, and the starting point may become higher. Therefoore, special techniques are needed to lower the starting point.

In this surgery, we tried to meet the patient’s needs as much as possible through a comprehensive approach, including complete removal of existing foreign bodies, reconstruction of the nasal septum, and correction of the tip and columella. In particular, it is noteworthy that we used a special method of sculpting the silicone implant to establish the starting point.

Another important point is that septoplasty and inferior turbinate reduction were performed together to solve the nasal congestion issue. This is a good example of achieving functional improvement as well as cosmetic improvement.

I hope this blog post is helpful for those who are concerned with a long, bulbous nose, with a high starting point that has complex issues, especially for the ones who had unsactisfactory results after undergoing a non-prosthetic rhinoplasty.

With Noselab Rhinoplasty Clinic you can achieve a beautiful and healthy nose.

Thank you.

Noselab Rhinoplasty Clinic

Dr. Chayoung Kang.