Upturned Nose Correction After 18 Years – Rib Cartilage Reconstruction Case Study

noselab
5월 3일
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최종 수정일: 9월 25일

Hello, this is Dr. Cha-Young Kang, Director of NOSELAB Clinic.

Today, I’m sharing a complex case of upturned nose correction using autologous rib cartilage. The patient had undergone four surgeries over 18 years and finally achieved a natural, balanced nasal structure.

Preoperative consultation photos for upturned nose correction, showing frontal, side, and oblique views with columella retraction and over-rotated nasal tip. — Design Consultation: Frontal View, Left Side View, and Oblique Side View Photos

Preoperative consultation images for upturned nose correction, featuring nostril view, right-side view, and oblique view highlighting columella retraction and nostril asymmetry. — Design Consultation: Nostril View, Right Side View, and Oblique Side View Photos

Surgical History and Initial Assessment

📍 Surgical History Overview

18 years ago: AlloDerm + silicone implant + ear cartilage graft (suspected infection → upturned nose)
17 years ago: Septal cartilage + ear cartilage + silicone revision (no improvement)
6 months later: Silicone removal
3 months later: Revision with silicone + cartilage graft

🔎 Preoperative Assessment

Frontal View:

Upturned nasal tip
Nostril asymmetry
Deviated nasal bridge

Side View:

Short, upturned nose
High nasion
Retracted columella
Long philtrum, protruding upper lip

Oblique & Nostril Views:

Severe nostril asymmetry
Leftward columella deviation
Scar tissue on upper columella

Nasal endoscopy images showing internal nasal cavity conditions, used in evaluating complications such as columella retraction and upturned nose. — Nasal Endoscopy Photos

Surgical Plan for Upturned Nose Correction

💉 Intraoperative Findings

Over ⅔ of alar cartilages removed in prior surgeries
Shallow nasolabial angle
Severe columella retraction and scar formation

🔨 Reconstruction Strategy

Lateral crus reconstructed with rib cartilage
Septal extension graft for nasal tip support
Columella lengthening and nasolabial angle correction
Nostril asymmetry and bridge height improved

Results After Upturned Nose Correction

✅ Postoperative Outcomes

Frontal comparison of upturned nose correction: Before (left) and immediately after surgery (right) showing improved nasal tip rotation and nostril balance. — Before (Left) / Immediately After (Right)

Frontal View:

Improved symmetry
Reduced nostril show
Straighter nasal bridge

Side View:

Lowered nasal starting point
Natural nasal tip projection
Shortened philtrum appearance

Before (Left) / Immediately After (Right)

Nostril View:

Balanced nostrils
Reduced scar visibility

👨‍⚕️ Surgeon’s Commentary

Immediately after upturned nose correction: frontal, side, and oblique side views showing improved nasal tip projection, reduced nostril exposure, and refined nasolabial angle. — Immediately After Surgery: Frontal, Side, and Oblique Side View Photos

Immediately after upturned nose correction: nostril view showing improved symmetry and reduced nostril exposure. — Immediately After Surgery: Nostril View Photos

This case of upturned nose correction highlights the complexity of reconstructing a nose after multiple failed surgeries. The upturned appearance wasn’t due to contracture, but to loss of structural support. Rib cartilage provided both stability and shape.

We also took precautions for cephalosporin allergy and rhinitis during planning.

Thanks to detailed analysis and precision, both aesthetic and functional success were achieved.

Thank you for reading.

This has been Dr. Cha-Young Kang, Director of NOSELAB Clinic.