Correcting a Deviated Nose and Hidden Columella: Autologous Rib Cartilage Reconstruction Case [Nose Lab Clinic]

Hello, this is Dr. Cha-Young Kang, Medical Director at Nose Lab Clinic.

Today, I’d like to share the story of a patient who underwent reconstructive surgery with autologous rib cartilage to address persistent nasal obstruction and structural asymmetry, including a deviated nose and a retracted columella, despite previous procedures.

📍 Surgical History of Rib Cartilage Nose Reconstruction

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

6–7 Years Ago

• Alar base reduction surgery

5 Years Ago

• Nasal tip surgery using ear cartilage

• Osteotomy and hump reduction

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

🔎 Initial Evaluation for Rib Cartilage Nose Reconstruction

Functional Concerns

• Chronic nasal congestion

• Deviated septum

• Persistent allergic rhinitis

Aesthetic Concerns

• Visible nasal deviation

• Retracted, poorly defined columella

• Recurred dorsal hump

• Prominent upper lip projection (protrusive profile)

• Overly narrow nasal dorsum

Key Findings

• Continued functional issues despite previous surgeries

• Structurally unstable nasal framework

• Inadequate tip support from prior ear cartilage grafts

✨ Patient Goals for Rib Cartilage Nose Reconstruction

• Restore columella visibility

• Correct nasal deviation

• Redo hump reduction

• Improve profile by reducing the appearance of lip protrusion

• Create a more balanced and appropriately thick nasal dorsum

💉 Rib Cartilage Nose Reconstruction Surgical Plan

Structural Reconstruction

• Full nasal framework reconstruction using autologous rib cartilage

• Reinforcement of prior unstable grafts

• Precise realignment for nasal deviation correction

Aesthetic Enhancements

• Enhanced columella projection

• Natural revision of nasal hump

• Achieved a harmonious nasal line with adequate dorsum thickness

Functional Restoration

• Septoplasty for structural nasal obstruction

• Submucosal turbinate reduction to relieve chronic rhinitis

Profile Refinement

• Nasolabial angle adjustment to soften lip protrusion

• Balanced facial proportions for a more refined overall appearance

✅ Rib Cartilage Nose Reconstruction Results and Before & After Photos

Preoperative and immediate postoperative side view video showing nasal appearance after rib cartilage nose reconstruction.

Functional Outcomes

• Complete relief from nasal obstruction

• Significant improvement in breathing

• Noticeable reduction in rhinitis symptoms

Before (Left) / Immediately After (Right)

Frontal View

• Corrected nasal deviation

• Naturally contoured nasal dorsum with improved thickness

• Balanced facial symmetry

• Smoothed dorsal hump

Before (Left) / Immediately After (Right)

Side View

• Clearly visible and naturally projected columella

• Harmonious nasal tip position

• Refined nasolabial angle

• Subtle improvement in lip protrusion

Before (Left) / Immediately After (Right)

Overall Transformation

• Structurally reinforced nasal framework

• Sophisticated and natural aesthetic

• Harmonized overall facial proportions

Before (Left) / Immediately After (Right)

👨‍⚕️ Expert Commentary on Rib Cartilage Nose Reconstruction

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

Immediately After Surgery: Nostril View Photo

This case highlights the complexity of secondary nasal revision when both functional and aesthetic concerns remain unresolved after prior surgeries. Despite undergoing tip refinement and dorsal hump reduction five years ago, the patient continued to experience nasal obstruction and was dissatisfied with the appearance of his deviated nose and poorly defined columella.

Detailed evaluation revealed that the prior use of ear cartilage failed to provide sufficient structural support. Moreover, the hump had not been fully addressed, and the overly narrow dorsum lacked balance. These findings pointed to the need for a more comprehensive and durable reconstructive approach.

We performed a complete structural rebuild using autologous rib cartilage, which offers superior support and long-term stability compared to ear cartilage. This allowed us to realign the nasal axis, enhance the columella projection, and revise the hump with precision.

Functionally, we addressed the patient’s nasal congestion by correcting the deviated septum and reducing the hypertrophied turbinates, significantly improving his breathing and rhinitis symptoms.

The refinement of the nasolabial angle helped soften the appearance of upper lip protrusion, contributing to a more proportionate and balanced facial profile.

This successful revision exemplifies how persistent post-surgical issues—when accurately diagnosed and addressed with structured planning—can be fully resolved. The use of rib cartilage enabled a stable, long-lasting solution that the patient was highly satisfied with, both functionally and cosmetically.

Thank you,Dr. Cha-Young KangMedical Director, Nose Lab Clinic