Deviated Hooked Short Nose Correction with Rib Cartilage Reconstruction
- Dr. Chayoung Kang
- 2024년 9월 11일
- 5분 분량
최종 수정일: 1일 전
This case reviews deviated hooked short nose correction in a patient with nasal deviation, dorsal hump, short nasal length, nostril asymmetry, columella deviation, nasal congestion, rhinitis, and possible nasal valve narrowing. Surgery focused on structural alignment, nasal lengthening, hump reduction, septal correction, turbinate reduction, and functional airway improvement.
Author: Dr. Cha-Young Kang
Clinic: NoseLab Clinic
Published: 2024
Last Updated: 2026
Introduction
Hello, this is Dr. Cha-Young Kang of NoseLab Clinic.
This case involves deviated hooked short nose correction in a patient with a complex nasal deformity involving a deviated nasal bridge, dorsal hump, short nasal length, nostril asymmetry, columella deviation, and breathing-related symptoms.
The surgery was performed using a closed rhinoplasty / endonasal approach with autologous rib cartilage reconstruction and functional correction. The goal was to improve nasal alignment, lengthen the shortened structure, reduce the dorsal hump, and address nasal obstruction and rhinitis symptoms.
Case Background
The patient presented with a complex nasal deformity that affected both appearance and function. The nose appeared deviated and short, with a hooked nasal dorsum and asymmetry at the nasal base.
The patient also had functional symptoms, including nasal congestion and rhinitis. Preoperative evaluation suggested that the airway problem was related to septal deviation, inferior turbinate hypertrophy, and possible nasal valve narrowing.
Key Concerns
The key concerns included:
Deviated nasal structure
Hooked nasal dorsum
Short nasal length
Nostril asymmetry
Columella deviation
Nasal congestion
Rhinitis symptoms
Possible nasal valve narrowing
This case required both structural reconstruction and functional correction rather than simple cosmetic reshaping.
Preoperative Design and Functional Assessment
Preoperative evaluation included frontal, side profile, nostril, and nasal endoscopy views.
Frontal View
The frontal view showed deviation of the nasal bridge and imbalance of the lower nasal structure. The nasal axis appeared shifted, and the nostril shape was asymmetric.
Side Profile View
The side profile showed a hooked nasal dorsum and short nasal length. The relationship between the nasal bridge, nasal tip, and upper lip appeared imbalanced.
Nostril View
The nostril view showed nostril asymmetry and columella deviation. These findings suggested imbalance of the nasal base and internal support.
Nasal Endoscopy Findings
Nasal endoscopy showed internal findings related to nasal obstruction, including septal deviation and inferior turbinate hypertrophy. Possible nasal valve narrowing was also considered in the surgical plan.
These findings confirmed that both the external nasal shape and internal airway needed to be corrected together.
Surgical Background – Closed Rhinoplasty for Complex Nose Correction
In cases involving a deviated, hooked, and short nose, correction requires more than dorsal hump reduction. The septum, nasal bones, nasal tip support, airway, and nasal base must be evaluated together.
A closed rhinoplasty Korea approach was selected to allow internal structural correction without adding an external columellar incision. This approach was used to perform septal correction, rib cartilage support, nasal lengthening, hump reduction, osteotomy, and functional airway correction.
Structural Problems Identified
Preoperative findings showed both structural and functional problems.
Main Structural Findings
The main structural findings included:
Short nasal length affecting facial proportion
Deviated nasal bridge
Hooked nasal dorsum
Columella deviation
Nostril asymmetry
Possible nasal valve narrowing
Weak structural support
Inferior turbinate hypertrophy
Because the deformity involved multiple parts of the nose, the correction had to address alignment, length, dorsal contour, nasal tip support, and airflow at the same time.
Surgical Plan
Septal Correction
Septal correction was performed to improve central alignment and support. This step was important for both nasal shape and airway function.
Turbinate Reduction
Turbinate reduction was performed to improve airflow and reduce obstruction related to inferior turbinate hypertrophy and rhinitis symptoms.
Septal Extension with Rib Cartilage
Autologous rib cartilage was used for septal extension to lengthen the shortened nasal structure and stabilize the nasal tip. Rib cartilage was selected because stronger support was needed for both lengthening and reconstruction.
Nasal Tip Reconstruction
The nasal tip was reconstructed to improve projection, support, and balance. This helped address the shortened appearance and improve the relationship between the tip and nasal base.
Hump Reduction
The dorsal hump was reduced to create a smoother nasal profile. The reduction was planned together with tip support and nasal lengthening to avoid imbalance.
Osteotomy for Nasal Deviation
Osteotomy was performed to correct nasal deviation and improve the alignment of the nasal bones.
Nasolabial Angle Adjustment
The nasolabial angle was adjusted to improve the relationship between the nasal tip and upper lip. This helped create a more balanced side profile.
Surgical Results
Frontal View
From the frontal view, nasal symmetry improved, nostril exposure was reduced, and the nasal alignment appeared straighter after structural correction.
Side Profile View
From the side profile, the dorsal hump was reduced, nasal length improved, and the nasolabial angle appeared more balanced after reconstruction.
Oblique View
The oblique view showed a straighter nasal line and improved facial proportion after hump reduction, nasal lengthening, and structural reconstruction.
Nasal Base View
From the nasal base view, nostril symmetry improved, the columella appeared straighter, and the internal airway space appeared more open.
Functional Outcome
Nasal airflow improved after septal correction, turbinate reduction, and structural airway support. Nasal congestion and rhinitis-related obstruction were also reduced after functional correction.
Surgeon’s Commentary
Correction of a deviated, hooked, and short nose requires a combined structural and functional plan. If only the dorsal hump is reduced, the nose may still appear short, deviated, or imbalanced.
In this case, the nasal deformity involved the nasal bones, septum, dorsal line, nasal tip, nostrils, and internal airway. For that reason, septal correction, rib cartilage extension, hump reduction, osteotomy, and turbinate reduction were planned together.
Autologous rib cartilage was used because the nose required stronger support for nasal lengthening and tip stabilization. Rib cartilage can be useful when the correction requires both structural strength and controlled repositioning.
Functional correction was also important because the patient had nasal congestion, rhinitis symptoms, and possible nasal valve narrowing. A structure-first approach allowed the surgery to address both nasal shape and breathing function.
This case shows that deviated hooked short nose correction should be planned as a comprehensive reconstruction rather than isolated hump reduction or simple tip reshaping.
FAQ
Can a deviated, hooked, and short nose be corrected together?
Yes, these problems can be addressed together when the surgical plan includes nasal bone alignment, septal correction, hump reduction, and nasal lengthening. The exact plan depends on the patient’s anatomy and airway condition.
Why is rib cartilage used for short nose correction?
Rib cartilage may be used when strong structural support is needed to lengthen the nose and stabilize the tip. It is especially useful when septal cartilage is insufficient or when the case requires complex reconstruction.
Can breathing improve after functional rhinoplasty?
Breathing can improve when septal deviation, turbinate hypertrophy, nasal valve narrowing, or structural obstruction is corrected. The degree of improvement depends on the patient’s internal nasal condition.
Is hump reduction enough for a hooked nose?
Hump reduction alone may not be enough if the nose is also short, deviated, or structurally weak. In these cases, dorsal correction should be combined with septal support and tip reconstruction.
International Consultation
For international patients, a photo-based consultation may help clarify whether deviated nose correction, hooked nose correction, short nose correction, rib cartilage reconstruction, or functional airway surgery may be needed.
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Medical Disclosure
Surgical before-and-after photos show individual patient cases, and results may vary depending on each patient’s anatomy, tissue condition, surgical history, and healing process. Please consult your doctor for an individualized assessment.
After surgery, complications may occur, including infection, bleeding, allergic reaction, asymmetry, limited aesthetic or functional improvement, excessive scarring, skin problems, necrosis, or other complications.
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