5th Revision Rhinoplasty: Correcting an Upturned and Deviated Nose in Korea

noselab
2024년 9월 9일
3분 분량

최종 수정일: 9월 29일

Hello, this is Dr. Chayoung Kang, Director of Noselab Rhinoplasty Clinic. Today, I will introduce the case of a patient undergoing her 5th revision rhinoplasty, hoping to finally achieve her desired results. This case demonstrates the complexity of rhinoplasty and the importance of surgical expertise.

Patient’s Medical History for Revision Rhinoplasty

This patient’s rhinoplasty journey started in 2015:

2015: nose fillers
2018: threads, rhinoplasty using donated rib cartilage and septal cartilage, filler removal.
Beginning of 2022: Rhinoplasty using silicone and self-rib cartilage
2 weeks later (2022): silicone removal
2 months later (2022): rhinoplasty reusing self-rib cartilage, ear cartilage and insertion of silicone.
February 2023: surgery reusing self-rib cartilage, donated rib cartilage, autologous dermis transplant, nasal alar raising, and nostril lowering surgery.

Even though the patient underwent these many surgeries, the patient’s nose look upturned so she visited our clinic.

Preoperative Consultation and Analysis before Revision Rhinoplasty

Revision rhinoplasty Korea – preoperative frontal view of upturned and deviated nose — Frontal view

Excessively exposed nostrils
Wide and blunt nose tip
Distinct nostril asymmetry
The nose could be observed to be genrally bent to one side

Side profile view

High nose bridge starting point
Retracted nasolabial angle
Slightly droopy nose tip

Revision rhinoplasty Korea – preoperative 45-degree view of upturned and deviated nose — 45-degree angle

Upturned nose tip
Long philtrum

Revision rhinoplasty Korea – preoperative nostril view showing asymmetry of upturned and deviated nose — Nostril view

Severe nostril asymmmetry

The columella left nostril cartilage seems to be tilted

Surgical details

The following surgeries were performed using the closed rhinoplasty approach:

a) Rib cartilage harvesting and transplant

Since the septal cartilage used in the previous surgeries was severely damaged, we used self-rib cartilage as main material this time.
We reinforced the cartilage on both sides sufficiently through nose tip reconstruction.

b) Septal extension and correction

Straightening of the deviated septum in order to improve the nasal congestion.
Septal extension graft to raise the nose tip structure and improve the upturned nose appearance.

c) Inferior turbinates reduction

Removal of the submucosal tissue of the inferior turbinates using a high-frequency laser to improve the nasal congestion.

d) Nasolabial angle correction

Adjustment of the overall angle in between the nose tip and the philtrum to improve the facial balance.

e) Foreign body removal

Removal of the existing foreign body

f) Tipplasty

Delicatedly cut the blunt nose tip in order to make a natural shape.

g) Nostril correction

Improvement of the asymmetrical nostril shape.
Removal of the cartilage tilted towards the columella and the scar tissue.

Before and After Surgery Photos

Frontal view before surgery (left) after surgery (right)

The excessively exposed nostrils were covered naturally.
The wide and blunt nose tip became a more delicate shape.
Great improvement of the nostril asymmetry.
Straightening correction of the deviated nose.

Side profile view before surgery (left) after surgery (right)

The height of the nose bridge was naturally adjusted.
The previously retracted columella became naturally more curved and was appropriately lowered.
Overall improvement of the side profile after raising the nose tip.
Enhanced balance of the face as the protruding mouth improved.

45-degree angle view before surgery (left) after surgery (right)

The upturned nose tip can be seen lower and more natural.
The nose looks more elegant and three-dimensional.
Improvemenrt of the lenght of the philtrum.

Nostrils before surgery (left) after surgery (right)

Great improvement of the severe nostril asymmetry.
After the removal of the tilted cartilage on the left nostril and the scar tissue, the appearance looks more clean.

After Surgery Table Photos

Photos taken immediately after surgery, frontal view, 45-angle view, and side profile.

Overview

This is a case that showcases the positive change of a patient that despite having undergone several rhinoplasty surgeries, was unable to get satisfactory results. This patient’s case was a complex surgery that required skills and accuarte diagnosis and a meticulous surgical plan were very important.

In this patient’s case, the severely damaged cartilage used in the previous surgery was an issue. Therefore, we made a plan to obtain cosmetic improvement at the same time we firmly reconstructed and reinforced the nasal structure using the autologous rib cartilage.

The septal correction and the inferior turbinate reduction solved the nasal congestion. This is an example in which we can observe the importance of not only cosmetic enhancement, but also of the functional improvements.

This complicated revision case in particular, was completed successfully through the closed rhinoplasty method without creating additional scar tissue. In cases like this is where the complex skills and extensive experience is necessary, and is demonstrated in Noselab’s expertise.

With Noselab Rhinoplasty Clinic you can achieve a beautiful and healthy nose.

Thank you.

Noselab Rhinoplasty Clinic

Dr. Chayoung Kang.