Revision Rhinoplasty for Crooked, Short Nose with Exposed Nostrils – Using Minimally Calcified Autologous Rib Cartilage
- noselab
- 6일 전
- 2분 분량
Hello, this is Dr. Cha-Young Kang, Medical Director of NOSELAB Clinic.
Today, I’m sharing the case of a patient who presented with a crooked, short nose and prominent nostril exposure. We addressed these complex concerns using autologous rib cartilage—specifically selecting a portion with minimal calcification for optimal long-term stability.
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
15 years ago: Silicone implant and ear cartilage graft
🔎 Initial Assessment
Functional
Chronic rhinitis symptoms
Frontal View
Deviated nasal bridge
Overexposed nostrils
Bulbous nasal tip
Side View
Short nose
Upturned nasal tip
Drooping tip
High radix (nasal starting point)
✨ Patient Goals
Correct deviated nose
Lengthen the short nose
Lift the drooping tip
Address the upturned appearance
Lower the radix
Refine the bulbous tip
💉 Surgical Approach
Special Considerations
Preoperative chest X-ray revealed calcification in costal cartilage
Right 8th rib, with minimal calcification, selectively harvested to minimize complications and ensure long-term stability
Structural Enhancements
Structural reinforcement using autologous rib cartilage
Rearranged nasal framework to correct deviation
Septal extension to lengthen the short nose
Alar base lowering to reduce nostril show
Concurrent surgery to improve rhinitis symptoms
Aesthetic Refinement
Lowered radix for softer profile
Improved nasal length and projection
Corrected bulbous tip
Balanced nasolabial angle
✅ Surgical Results
Functional Outcome
Inferior turbinate volume reduced
Rhinitis symptoms expected to improve
Before (Left) / Immediately After (Right)
Frontal View
Straighter nasal alignment
Reduced nostril exposure
Harmonized nasal contours
Before (Left) / Immediately After (Right)
Side View
Appropriately lengthened nose
Improved nasal tip position
Lowered radix
Balanced nasolabial angle
Before (Left) / Immediately After (Right)
Nostril View
Enhanced nostril symmetry
Refined, balanced nostril shape
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 a complex presentation of structural and aesthetic challenges, including a deviated and short nose, drooping tip, excessive nostril show, and functional nasal obstruction—all stemming from a prior surgery performed 15 years ago using silicone and ear cartilage.
A key highlight was the preoperative detection of costal cartilage calcification via chest X-ray. This allowed us to safely select the right 8th rib with minimal calcification, which is critical for avoiding complications such as pneumothorax during harvest and for securing a stable long-term outcome. Heavily calcified cartilage may not be viable for grafting, underscoring the importance of this preoperative screening.
We addressed the structural issues through septal extension and reconstruction using the autologous rib graft. The excessive nostril show, particularly noticeable from the front, was improved via alar base lowering. The high radix and upturned appearance were corrected by fine-tuning the nasal framework, and the bulbous tip was carefully reshaped for a more refined yet natural look.
In tandem, functional procedures for rhinitis and turbinate reduction helped improve breathing quality. This comprehensive, multi-dimensional approach not only met the patient’s aesthetic goals but also ensured functional integrity—backed by structurally sound grafting and long-term safety.
Thank you for reading.
This has been Dr. Cha-Young Kang from NOSELAB Clinic.
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