Precise Revision Rhinoplasty for Crooked Nose and Columella Asymmetry

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

Today, I’d like to share a case of detailed revision rhinoplasty for a patient who had long struggled with a crooked nose and columella asymmetry.

Design Consultation: Frontal View, Left Side View, and Oblique Side View Photos

Design Consultation: Right Oblique Side View, Side View, and Nostril View Photos

📍 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

🔎 Initial Findings

• Loose, mobile silicone implant

• Residual foreign material on the left glabella (forehead-nose junction)

• Asymmetric nasal bones

• Deviated nasal bridge

• Columella leaning left with asymmetry

✨ Patient Goals

• Correct nasal deviation

• Restore symmetrical columella shape

• Resolve implant mobility

💉 Surgical Plan

Structural Reconstruction

• Complete removal of residual material in the left glabella

• Lateral osteotomy to correct asymmetrical nasal bones

• Repositioning and reconstruction of the septum to center the columella

• Reinforcement of the septum with autologous rib cartilage

• Removal of the previous silicone implant

Aesthetic Refinement

• Lowering and repositioning the nasal root for a more balanced starting point

• Adjusting the nasolabial angle for a smoother profile

• Correcting the crooked nasal bridge

• Achieving symmetry in the columella and nasal base

✅ Postoperative Outcomes

Before (Left) / Immediately After (Right)

Frontal View

• Straightened nasal bridge

• Centralized and balanced columella

• Harmonious, symmetrical nasal shape

• Natural nasal root starting point

Before (Left) / Immediately After (Right)

Side View

• Smooth and refined nasal dorsum

• Strong, stable nasal structure

• Enhanced nasolabial angle

• Improved overall facial balance

Before (Left) / Immediately After (Right)

Nostril View

• Corrected nostril asymmetry

• Realigned columella

• Balanced nostril contour

Before (Left) / Immediately After (Right)

👨‍⚕️ Expert Commentary

Immediately After Surgery: Frontal, Side, and Oblique Side View Photos

Immediately After Surgery: Nostril View Photo

This case involved highly meticulous correction of complex nasal asymmetries, following multiple previous surgeries. The patient sought subtle yet precise improvements, particularly in the alignment of the nose and columella.

We began by removing residual foreign material in the glabella, which contributed to the distorted appearance. To realign the nose, we performed lateral osteotomies and repositioned the deviated septum using a partial reconstruction technique. Autologous rib cartilage was used to strengthen the internal nasal structure.

Special attention was given to the columella and nostril asymmetry. We centered the columella and corrected its tilt, improving the nasal tip projection and base alignment. By adjusting the nasolabial angle and nasal root starting point, we ensured the results were not only structurally sound but also aesthetically refined.

This case highlights how detailed, individualized planning and execution can yield natural and satisfying outcomes, even in revision scenarios with complex anatomy.

Thank you for reading.

This has been Dr. Cha-Young Kang from NOSELAB Clinic.

https://blog.naver.com/cykang/223856281386