Hello, this is Dr. Chayoung Kang, Director of Noselab Rhinoplasty Clinic. Today, we will introduce of a patient with an upturned nose and nostril asymmetry who had an incredible transformation.
I hope this spceial case gives those who have a small and thin skin some hope.
Preoperative Design Consultation
This patient had undergone a rhinoplasty 15 years ago, using silicon implant and ear cartilage. However, she was not able to receive satisfactory results. The main issues that she had with her results were the following:
Excessive noticeable nostril asymmetry
Nasal deviation to the left side
Bumpy nose bridge shape
Necessary protruding mouth correction
Symptoms of nasal congestion
Frontal view
Nose tip bent to the right side
The nostrils are excessively visible and asymmetric on both sides due to the pinched appearance of the right nostril.
The starting point of the nos bridge is too high that it makes the nose long even though it is small.
Side profile view
Droopy nose tip
Bumpy nose bridge
The nostrils are too visible on the side profile view
The starting point of the nasal bridge is too high
45-degree view
Long nose
High nose bridge starting point
Nostril view
The right nostril is tilted to the right side
Columella pulled to the right side
Severe nostril asymmetry
In particular, the patient’s nose was small and the skin thin, which made the level of difficulty of the surgery even higher.
Surgical Details
The following surgeries were performed using the closed rhinoplasty approach:
a) Septal cartilage reconstruction and correction:
During the surgery, we observed that the septal cartilage was very thin and was definitely bent to the right side.
The septal cartilage was completely detached from the maxillary bone, so we proceeded with its reconstruction using the autologous rib cartilage.
Through this septal correction surgery we were able to improve the nasal congestion.
b) Nose tip and nasal alar correction:
Using the septal rib cartilage we firmly lowered the nose tip.
To reinforce the alar cartilage we performed a nostril extension.
c) Skin reinforcement:
Since the skin was too small and thin, we had to solve this issue in a complex manner using artificial dermis and the scar tissues that had appeared inside of the nose to sufficiently reinforce the skin.
We made the transplanted cartilage wider in order to prevent it from being visible.
d) Nose bridge correction:
Determining the degree in which the nose tip would be raised and adjusting the correct height of the nose bridge accordingly.
e) Inferior turbinates reduction:
Additional improvement of the nasal congestion by performing a turbinate submucosal resection using a high-frequency laser.
Before and After Surgery Photos
Correction of the nose tip that was deviated to the right side.
There was a great improvement of the nostril asymmetry. The excessively visible nostrils were covered naturally.
The high nose bridge starting point became lowered, and in general the lenght of the nose improved.
Lowering of the nose bridge starting point
The nasal hump disappeared.
There was a improved effect on the mouth protrusion through the nasolabial angle natural correction.
The nose tip that was leaning to the right side was fixed on the center.
Improvement of the columella that was being swept to the right side.
Visual improvement of the nostril asymmetry.
After Surgery Table Photos
Overview
This case was about a solving various complex issues of a patient who had a thin-skinned and small nose. In particular, the points worth of highlighting are the following:
Septal reconstruction: safely reinforcement of the nasal structure of the previously severely deformed septum by using autologous rib cartilage to completely reoconstruct it.
Skin reinforcement: we reinforced the skin using scar tissue and artificial dermis in order to prevent the cartilage to be seen through due to the thinness of the skin.
Nostril extension: to solve the issue of the excessively visible nostrils, we performed a nostril extension. Through this procedure, we reduced the nostril exposure, and we were able to maintain a natural nose shape.
Functional improvement: we performed a septal extension graft a inferior turbinate reduction surgery to improve the symptoms of nasal congestion. This does not only provide cosmetic improvement, but also brings great help to the patient’s life.
The biggest issue in this surgery is that the skin was small and thin. Due to this condition, the cartilage could be visible or the skin may not be enough in order to stretch the skin as much as needed to obtain natural results. However, through appropriate skin reinforcement techniques and careful cartilage adjustment, we were able to overcome this issues successfully.
Through the closed rhinoplasty approach, we were able to ensure a shorter recovery period, and avoid leaving external scars, which increased the patient’s satisfaction.
All procedures were performed using a closed approach, completing the surgery without external scars.
With Noselab Rhinoplasty Clinic you can achieve a beautiful and healthy nose.
Thank you.
Noselab Rhinoplasty Clinic
Dr. Chayoung Kang.
Comments