Nasal Bone Fracture Reconstruction and Dorsal Refinement – A Two-Stage Closed Rhinoplasty Case

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최종 수정일: 9월 25일

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

Today, I’m sharing a real case of nasal bone fracture reconstruction combined with aesthetic correction for an excessively high nasal dorsum.

📍 Patient History and Nasal Trauma

Preoperative design consultation photos of a male patient – frontal, left side, and oblique side views for closed rhinoplasty planning — Design Consultation: Frontal View, Left Side View, and Oblique Side View Photos

6 years ago: Nasal filler (later dissolved)
4 years ago: Silicone and rib cartilage rhinoplasty
1 week ago: Nasal trauma resulting in a bone fracture

🔎 Initial Analysis – Fracture and Structural Deformities

eoperative design consultation images of a male patient – right side view, oblique side view, and nostril base view taken for closed rhinoplasty planning. — Design Consultation: Right Side View, Oblique Side View, and Nostril View Photos

1. Frontal View

Nasal bone severely deviated to the right
Nasal tip shifted
Broad and unbalanced nasal shape

2. Side View

Dorsum overly elevated
Drooping nasal tip
Retracted columella

3. Nostril View

Asymmetrical nostrils
Deviated columella to the right

✨ Patient’s Concerns and Goals

Repositioning of fractured nasal bone
Lowering the excessive dorsal height
Aesthetic nasal refinement
Long-term structural stability

ℹ️ Can Nasal Bone Fracture Reconstruction and Aesthetic Surgery Be Performed Together?

CT scan classification of nasal bone fractures by type – Type I, IIo, IIs, IIIo, IIIs, and IV – showing anatomical diagrams and corresponding coronal and axial CT images. — Figure 1. Classification of nasal bone fracture." from Kim JH, Lee JW, Park CH. Cosmetic Rhinoseptoplasty in Acute Nasal Bone Fracture. Otolaryngology Head and Neck Surgery. 2013;149(2). DOI:10.1177/0194599813487493

https://pubmed.ncbi.nlm.nih.gov/23812981/

The possibility depends on the fracture type:

Type I, IIo, IIs: Cosmetic surgery can be done simultaneously
Type IIIo & IIIs: Case-by-case evaluation recommended
Type IV: Cosmetic surgery is not recommended initially

This case was classified as Type IIIo, and we chose a two-stage closed approach.

💉 Surgical Strategy – Staged Closed Rhinoplasty

First Stage

Closed nasal fracture reduction
Tip reconstruction using rib cartilage
No implant used – structural integrity prioritized

Second Stage (Planned)

Dorsal augmentation with rib cartilage after bone healing
Final adjustments for aesthetic refinement

✅ Postoperative Results – After the First Stage

rontal view comparison before (left) and immediately after (right) nasal fracture reconstruction and high dorsum correction surgery. — Before Surgery (Left) / Immediately After Surgery (Right)

Frontal View

Nasal bone realigned
Tip corrected and centralized
Balanced facial symmetry

Side View

Tip projection restored
Columella repositioned
Dorsal height to be refined in Stage 2

Nostril View

Nostril symmetry improved
Columella axis corrected
Nasal tip support stabilized

👨‍⚕️ Surgeon’s Commentary – Why We Chose Closed Rhinoplasty

코뼈 재건 직후 촬영된 정면, 측면, 비스듬한 측면 사진으로 수술 직후 부기와 정렬 상태를 보여줌 — Immediately After Surgery: Frontal, Side, and Oblique Side View Photos

This case presented both trauma and aesthetic complexity. A closed rhinoplasty approach allowed minimal tissue trauma while securing solid internal reconstruction with rib cartilage. CT scans also showed previous osteotomy remnants, which made precise correction more challenging.

Deferring dorsal refinement to Stage 2 ensures a safer and more satisfying result. Even after the first stage, the improvement in nasal structure and tip alignment is significant.

At NOSELAB, all surgeries are performed using a closed rhinoplasty approach.

Thank you for reading.

This has been Dr. Cha-Young Kang, Director of NOSELAB Clinic.