Hello, this is Dr. Chayoung Kang, Director of Noselab Rhinoplasty Clinic. Today, we will introduce the rhinoplasty case of a patient who had an upturned nose, with excessively exposed nostrils, who came to our clinic to change it into a naturally-looking straight nose.
This patient had undergone several rhinoplasty surgeries, and used various materials.
A complicated case like this needs careful analysis and an appropriate surgical plan.
Preoperative Design Consultation
First, let’s take a look at the patient’s medical history:
2016: silicone + ear cartilage
2018: dermis + ear cartilage
7 months after: silicone + septal cartilage + donated rib cartilage
2021: silicone + donated rib cartilage
Even after all of these rhinoplasty surgeries, the patient was unable to get satisfactory results. Let’s analyze the patient’s condition prior to the surgery:
Excessively visible nostrils and the right nostril looks pinched.
The starting point of the glabella looks high giving a strong impression.
The nose looks deviated due to nasal bone asymmetry present on both sides.
Unnatural nose shape due to the high glabella starting point.
Upturned nose tip.
Protruding mouth and long philtrum.
Retracted columella.
Bumpy nose bridge
HIgh nasal bridge starting point
Upturned nose tip
Nostril asymmetry
Titled columella
To solve these complex issues, we came up with the following surgical plan:
2. Surgical Plan
Septal reconstruction using autologous rib cartilage
Septal extension graft
Nasal alar cartilage reconstruction on both sides (with autologous rib cartilage)
Nostril lowering surgery
Lateral osteotomy (to correct the deviated nose bridge)
This plan was determined taking into account he patient’s medical history and condition in order to achieve optimal results. We used self-rib cartilage at the nose tip specifically to obtain stable and secure results for the long-run
Before and After Surgery Photos
Covered the overly-exposed nostrils
Improved the pinched nose tip to a softer and more natural appearance.
The high glabella starting point was lowered making the appearance softer.
Improvement of the nasal bone asymmetry making it look straight overall.
The nose shape became more natural-looking
The upturned nose was lowered and improved the overall harmony.
Improvement of the mouth protrusion, giving the philtrum a shorter appearance.
The retracted columella was improved naturally.
Smoother nose bridge.
Softer nose shape after lowering the nasal bridge starting point.
Natural-looking correction of the upturned nose tip.
Improvement of the nostril asymmetry.
Straightening of the tilted columella.
After Surgery Table Photos
Overview
This case is one that addresses the complex problems that can occur after multiple rhinoplasty surgeries. In particular, overall structural reconstruction using autologous costal cartilage played a key role.
The height of the nose bridge of the nose is not simply determined when raising it, but it must be determined by comprehensively considering the height of the patient’s forehead and eyebrow bone, as well as the shape and height of the tip of the nose. In this process, the starting point of the glabella and the nasolabial angle are very important factors.
In this patient’s case, the bridge of the nose was raised too high in the previous surgery, so the connection with the tip of the nose was very unnatural and artificial. The shape of the nose is important, but it is also very important to match the proportions of the entire face.
This surgery allowed us to solve the problems of the upturned nose and exposed nostrils while creating a natural nose shape that takes into account the overall facial balance. In particular, by using a closed rhinoplasty approach, we were able to shorten the postoperative recovery period and complete the surgery without leaving external scars.
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