Hello, this is Dr. Cha-Young Kang, Director of Nose Lab Clinic.
Today, I’d like to share a unique case involving a male patient in his 30s who sought a natural look after multiple rhinoplasty procedures. He came to us wanting to address the asymmetry, deviation, and overly reduced nostrils from his previous surgeries.
1. Surgical History and Planning
The patient had undergone several rhinoplasty procedures:
8 years ago: Nostril reduction, silicone implant, and cartilage grafts (exact details unknown)
6 years ago: Revision with silicone and donor rib cartilage
5 years ago: Another revision with silicone and donor rib cartilage due to dissatisfaction with the appearance
4th Revision Surgical Plan:
Correct asymmetry
Replace the misaligned implant
Adjust the columella to improve nostril symmetry
Reduce visible nostril exposure
Adjust the nasolabial angle
Lower the columella
Improve cartilage support in the tip
Maintain current bridge height
2. Pre-Surgical Analysis
The initial assessment showed several unique characteristics:
Front View: A distinctively shaped tip with pronounced nostril asymmetry; the left nostril appeared pinched, and the columella was retracted. Adhesion from previous surgeries caused indentations around the nasal wings, and the bridge appeared deviated.
Side View: Signs of upper lip protrusion, retracted columella, and a nasolabial angle of less than 90 degrees.
Nostril View: The right nostril appeared smaller, with noticeable scarring on the columella and visible marks from previous nostril reduction.
3. Surgical Plan
Due to prior over-reduction of the nostrils, full symmetry was challenging, so we aimed to improve balance through the following:
Septal Reconstruction with Autologous Rib Cartilage: Moving the septum slightly to the left to maximize symmetry.
Alar Cartilage Adjustment: To improve the nasal tip’s shape and provide structural support.
Replacing the Implant: Removing the old implant and centering a new one to straighten the bridge.
Adjusting the Nasolabial Angle: Targeting a 90-degree angle for a balanced profile.
Columella and Nostril Refinement: Repositioning the columella and adjusting nostrils for improved symmetry.
4. Surgical Outcome
Before Surgery (Left) / Immediately After Surgery (Right)
Before Surgery (Left) / Immediately After Surgery (Right)
Before Surgery (Left) / Immediately After Surgery (Right)
The results were transformative and addressed the patient’s concerns:
Front View: The visible nostril exposure was reduced by over half, and asymmetry was significantly improved. The bridge was straightened, and indentations near the nasal wings were less pronounced.
Side View: The columella now appears naturally between the nasal wings, with the nasolabial angle adjusted to around 90 degrees, improving the overall balance and reducing the appearance of upper lip protrusion.
Before Surgery (Left) / Immediately After Surgery (Right)
Nostril View: Moving the septal cartilage leftward helped reshape the right nostril, making it closer in size and shape to the left. Adjusting and suturing the alar cartilage reduced the pinched appearance of the left nostril.
5.Final Thoughts
Many people desire an impressive, contoured nose when first considering rhinoplasty. However, it’s essential to consider each individual’s unique anatomy. Pursuing excessive height or dramatic contours can lead to challenges, as certain procedures, such as extensive nostril reduction, are difficult to reverse.
At Nose Lab Clinic, we emphasize the importance of a balanced approach that enhances the nose’s natural characteristics. If you’re considering rhinoplasty, consulting with an experienced specialist can help guide you toward results that prioritize both safety and a natural look.
Thank you for reading, and I hope this story provides helpful insights. At Nose Lab Clinic, we are committed to helping you achieve a healthy, beautiful nose that complements your unique features.
Warm regards,
Dr. Cha-Young Kang, Director of Nose Lab Clinic
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