Nostril Asymmetry Correction – Revision Rhinoplasty in Korea

noselab
2024년 6월 20일
3분 분량

최종 수정일: 18분 전

Hello! This is Dr. Chayoung Kang, Director of Noselab Clinic.

Today I would like to share a case of nostril asymmetry correction performed as a revision rhinoplasty.

The patient had undergone multiple surgeries at other clinics but was told that the asymmetry of the nostrils could not be fixed. In reality, correcting nostril asymmetry is much more complex than it may seem.

Preoperative Analysis of Nostril Asymmetry

From the front, the nostrils were significantly visible, and the asymmetry was noticeable. Moreover, the nose was bent to the left, and, as observed in the CT taken at our hospital, the silicone prosthesis had actually gone over the left side. When looking at a photo of the nostrils, it could be observed that the columella was also going to the left side, and the nose tip cartilage was lifted and misaligned with the columella. The nasal congestion on the right side was severe, and the CT and endoscopy findings revealed that at the upper part, the septum was on the right side, and in the bottom part, the septum, was partially to the left side. Also, we found the presence of hypertrophic rhinitis in both sides.

Endoscopic view of nasal cavity before nostril asymmetry correction, showing silicone implant deviation to the left and asymmetry of the nasal septum and bone structure.

Endoscopic photos taken before the surgery.

The silicone implant was bent to the left.
Asymmetry of the nasal bone. The part connecting the nasal bone and the nose tip cartilage was crooked.
The columella was bent to the left.
The forehead was too high in comparison to the point in between the eyebrows.
The nose tip looked droopy in comparison to the nose bridge.
Complaints of nasal congestion on the right side.

Frontal and side view photos showing preoperative consultation design for nostril asymmetry correction, indicating nasal deviation to the left and planned adjustments for nose bridge and tip alignment.

Frontal view: Consultation design before the surgery.

Nostril base view photo showing preoperative consultation design for nostril asymmetry correction, highlighting the tilted columella and uneven nostril shape before surgery.

Nostril view: Consultation design before the surgery.

Surgical Plan and Techniques for Nostril Asymmetry Correction

The silicone implant was bent to the left. ➜ Insertion of an new silicone implant and sculpt it to fit the nasal bone.

Asymmetry of the nasal bone. The part connecting the nasal bone and the nose tip cartilage was crooked. ➜ Outer osteotomy and using a silicone implant.

The columella was bent to the left. ➜ Lowering the columella by using self-rib cartilage.

Nostril asymmetry ➜ Presumed to be improved as the nose bridge is straightened.

The forehead was too high in comparison to the point in between the eyebrows. ➜ Lowering the starting point of the silicone approximately to the height of the pupil line.

The nose tip looked droopy in comparison to the nose bridge. ➜ Improved by using the self-rib cartilage in the nose tip to perform a septal extension graft.

Complaints of nasal congestion on the right side. ➜ Septal reconstruction and performing a submucosal resection using a high-frequency laser.

Before and After Surgery Photos

Photos were taken immediately before and after the surgery with the consent of the patient.

I fixed the most visibly asymmetric parts of the nostrils. At the time of the surgery, it was confirmed that the condition was worse than we had planned. In the previous surgery, there was a large amount of septal cartilage collected from the bone, so the septum had barely any stability. The bottom of septal cartilage and nasal bone were separated and were crumpled to the left side. The anterior nasal spine [see below] at the bottom part of the columella was firmly fixed, and both sides were reinforced with the self-rib cartilage, which fixed the nostril asymmetry.

Medical illustration showing the anterior nasal spine located at the base of the columella, demonstrating its role in supporting nasal symmetry during nostril asymmetry correction surgery.

Anterior Nasal Spine reference image

Photos taken after the surgery with the consent of the patient.

As planned before the surgery, everything went well during the operation, and as observed in the photos taken after the surgery, the parts that the patient wanted to correct, were improved satisfactorily.

Dr. Chayoung Kang

Director of Noselab Clinic