Reconstruction After Nasal Bone Fracture and High Dorsum Correction โ Real Case Review
- noselab
- 5์ผ ์
- 3๋ถ ๋ถ๋
์ต์ข ์์ ์ผ: 5์ผ ์
Hello, this is Dr. Cha-Young Kang, Director of NOSELAB Clinic.
Today, Iโd like to share the case of a patient who underwent successful nasal reconstruction following a nasal bone fracture, along with aesthetic correction for a previously overly high nasal dorsum.
Design Consultation: Frontal View, Left Side View, and Oblique Side View Photos
๐ Surgical History
6 years ago: Nasal filler, later dissolved
4 years ago: Rib cartilage + silicone rhinoplasty
1 week ago: Nasal bone fracture
๐ Initial Evaluation
Design Consultation: Right Side View, Oblique Side View, and Nostril View Photos
1. Frontal View
Severely deviated nasal bone (to the right)
Nasal tip shifted to the right
Broad nasal shape
2. Side View
Overly high nasal bridge
Drooping nasal tip
Retracted columella
3. Nostril View
Deviated columella toward the right
Nostril asymmetry
โจ Patient's Requests
Precise reduction of nasal bone fracture
Lowering the overly high nasal dorsum
Aesthetic refinement
โน๏ธ Can a Nasal Fracture and Cosmetic Surgery Be Done Together?
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
The feasibility of combining cosmetic surgery with nasal bone fracture correction depends on the fracture type:
Type I, IIo, IIs: Simple fractures โ cosmetic surgery can be done concurrently
Type IIIo & IIIs: Comminuted oblique/sagittal fractures โ careful case-by-case consideration
Type IV: Multiple fractures involving ethmoid bone โ cosmetic surgery is not recommended initially
This patient was classified as Type IIIo, so we opted for a staged approach:
Step 1: Nasal bone realignment and tip reconstruction using rib cartilage
Step 2 (Planned): Dorsal refinement and augmentation with rib cartilage after 3 months, once healing is complete
๐ Surgical Details
1. Nasal Fracture Assessment
CT confirmed multiple fracture lines, including previous osteotomy marks
Planned non-open (closed) reduction to minimize tissue trauma
2. First Stage Surgery
Non-open fracture reduction
Nasal tip reconstruction with rib cartilage (columellar extension)
No implant used to prioritize stability and healing.
3. Second Stage (Planned)
Rib cartilage dorsal augmentation after bone healing
Final aesthetic adjustments
โ Postoperative Outcome
Before (Left) / Immediately After (Right)
Frontal View
Corrected bone alignment
Straightened nasal tip
Improved facial symmetry
Before (Left) / Immediately After (Right)
Side View
Repositioned nasal tip and columella
Stable, natural tip projection
Dorsal height adjustment to be completed in second stage
Before (Left) / Immediately After (Right)
Nostril View
Improved columellar alignment
Enhanced nostril symmetry
Secured nasal tip support
๐จโโ๏ธ Surgeonโs Insight
Immediately After Surgery: Frontal, Side, and Oblique Side View Photos
This case required a careful balance between trauma management and cosmetic refinement. Due to the complexity of a Type IIIo nasal fracture, we chose a two-stage approach to ensure both safety and optimal long-term results.
Interestingly, some of the fracture lines seen on the CT were remnants from a previous osteotomy. Through closed reduction and rib cartilage reconstruction, we were able to stabilize the nasal structure and improve both function and appearance.
Dorsal height correction was deferred to the second stage to allow proper healing and ensure a safe and satisfying outcome. Even after the first stage alone, the improvement in bone alignment and nasal tip positioning was significant.
We expect an excellent final result following the second procedure in 3 months.
Thank you for reading.
This has been Dr. Cha-Young Kang, Director of NOSELAB Clinic.
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