Case at a glance
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Hello, this is Dr. Chayoung Kang, Director of Noselab Rhinoplasty Clinic. Today, we will introduce the case of a patient who visited our clinic after developing nasal congestion and shape deformation following nasal trauma.


This patient had been in an accident a month before, which caused trauma to her nose and resulted in nasal congestion and deformation. She came to our hospital for nasal trauma correction.


Patient’s Medical Record – Trauma and Nasal Trauma Correction


  • 7 years before: tip plasty using the septal cartilage.

  • One month later, someone impacted her nose with an elbow.

  • After the accident, she developed symptoms of nasal congestion and shape deformation.


Preoperative Design Consultation for Nasal Trauma Correction

Preoperative design consultation, frontal view, 45-degree view and side profile view.
Preoperative design consultation, frontal view, 45-degree view and side profile view.
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Nostril view
Nostril view
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Frontal view:

  • The right side of the nose tip was tilted.

  • Noticeable nostril asymmetry.

  • Visible nostrils.


Side profile view:

  • Droopy nose tip

  • Bumpy nasal dorsum

  • Pointy-looking nose tip


45-degree view:

  • The nose tip looks upturned while also being droopy


Nostrils:

  • Columella tilted to the right side.

  • Nose tip tilted to the right side.

  • Noticeable nostril asymmetry.


CT findings:

CT endoscopic images showing septal deviation and suspected septal cartilage fracture after nasal trauma.
Case photograph 3
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  • The left side of the septal cartilage was tilted (septal deviation)

  • Suspected fracture of the septal cartilage due to the trauma


Surgical Plan

To solve these complex issues, we came up with the following surgical plan:


  • Septal correction and reconstruction

  • Septal graft extension using donated rib cartilage.

  • Correction of the bent nose tip

  • Raising the nose bridge (non-prosthetic)

  • Nasal bone asymmetry correction through a lateral osteotomy.


Before and After Surgery Photos

Frontal view before surgery (left) after surgery (right)
Frontal view before surgery (left) after surgery (right)
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  • The nose tip that was tilted to the right side was centered in the middle.

  • Great improvement of the nostril asymmetry.

  • Lowered the exposure of the nostrils.


Side profile view before surgery (left) after surgery (right)
Side profile view before surgery (left) after surgery (right)
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  • The droopy nose tip was naturally elevated.

  • The bumpy nasal dorsum was made smooth.

  • Improvement of the condition of the pointy nose tip into a softer shape.


45-degree angle view before surgery (left) after surgery (right)
45-degree angle view before surgery (left) after surgery (right)
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  • The droopy and upturned nose tip became raised in a natural-looking manner.

  • Harmony improvement of the overall nose shape.

Nostrils before surgery (left) after surgery (right)
Nostrils before surgery (left) after surgery (right)
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  • The columella that was tilted to the right side was adjusted to the center.

  • Symmetry improvement of the bent nose tip.

  • Visible improvement of the nostril asymmetry.


After Surgery Table Photos

Photos taken immediately after surgery, frontal view, 45-angle view, and side profile.
Photos taken immediately after surgery, frontal view, 45-angle view, and side profile.
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Photo of the nostrils
Photo of the nostrils
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Overview


This case is about solving functional issues and shape deformation that occured due to trauma at the same time. There are some noteworthy points about this case as follows:


  • Importance of an accurate diagnosis: definite diagnosis of septal cartilage fracture and deviation through a CT scan.

  • Functional and cosmetic balance: improvement of the nasal congestion at the same time that a natural nose shape was created.

  • Non-prosthetic rhinoplasty: As the patient had requested, we obtained natural and safe results using only autologous tissue.

  • Closed rhinoplasty approach: successfully performed a complex reconstructive surgery without leaving external scars.

Postoperative precautions and possible complications after rhinoplasty – includes information on infection, bleeding, asymmetry, allergic reactions, and scarring.
Case photograph 10
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