Precise Revision Rhinoplasty for Crooked Nose and Columella Asymmetry

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

This was a complex **revision rhinoplasty** case addressing both a **crooked nose** and **columella asymmetry**. The patient had previously undergone multiple rhinoplasty procedures, but continued to struggle with noticeable deviation and imbalance in the nasal structure.

Revision Rhinoplasty History – Multiple Procedures and Failures

Preoperative design consultation photos: Frontal view, left oblique side view, and left side view.

Surgical History

• 10 years ago: Filler injection (later dissolved)

• 8 years ago: Silicone implant + ear cartilage graft

• 9 months ago: Autologous rib cartilage + silicone implant surgery

Crooked Nose and Columella Asymmetry – Preoperative Findings

Preoperative design consultation photos: Right side view, right oblique side view, and nostril view.

The patient presented with:

• A loose, mobile silicone implant

• Residual foreign material on the left glabella (forehead–nasal bridge junction)

• Asymmetric nasal bones

• A deviated nasal bridge

• Columella tilting to the left

Patient’s Goals – Revision Rhinoplasty for Crooked Nose and Columella Asymmetry

• Correct overall nasal deviation

• Realign and centralize the columella

• Eliminate implant mobility

• Improve facial balance with natural results

Surgical Plan – Correcting Crooked Nose and Columella Asymmetry

Structural Reconstruction

• Removal of residual glabellar material

• Lateral osteotomy to fix nasal bone asymmetry

• Repositioning of the septum to centralize the columella

• Septal reinforcement using autologous rib cartilage

• Removal of the previous silicone implant

Aesthetic Refinement

• Lowering the nasal radix to harmonize the starting point

• Adjusting the nasolabial angle for improved tip rotation

• Straightening the nasal bridge

• Achieving symmetry in the columella and nostrils

Postoperative Results – Crooked Nose and Columella Asymmetry Corrected

Before Surgery (Left) / Immediately After Surgery (Right)

Frontal View

• Nasal axis straightened

• Columella centered

• Overall facial symmetry improved

Before Surgery (Left) / Immediately After Surgery (Right)

Side View

• Smooth, balanced nasal dorsum

• Refined nasolabial angle

• Strong, stable nasal structure

Before Surgery (Left) / Immediately After Surgery (Right)

Nostril View

• Asymmetry corrected

• Columella repositioned

• Nostril base recontoured

Before Surgery (Left) / Immediately After Surgery (Right)

Expert Insights – Revision Rhinoplasty for Complex Nasal Asymmetries

Immediately after surgery: Frontal view, side view, and oblique side view photos.

Immediately after surgery: Nostril view photos.

This case involved highly meticulous correction of complex nasal asymmetries after multiple prior surgeries.

Residual foreign material in the glabella was first removed to correct distortion. Lateral osteotomies and septal repositioning with autologous rib cartilage provided stable internal support.

Special focus was placed on columella asymmetry and nostril balance. By repositioning the columella and adjusting the nasolabial angle, we achieved a natural, symmetric, and structurally sound outcome.

This case demonstrates how individualized revision techniques can restore both function and aesthetics, even after several failed procedures.

Final Thoughts from Dr. Cha–Young Kang

If you are considering revision rhinoplasty due to crooked nose or columella asymmetry, it’s essential to consult with a surgeon experienced in managing complex nasal anatomy.

At NOSELAB, we focus on achieving harmony, stability, and natural refinement—personalized for each patient.

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