Hello, this is Dr. Cha-Young Kang, the chief surgeon at NoseLab Clinic.
Today, I’d like to introduce a rhinoplasty case involving a patient who was concerned about a dorsal hump and a long nose.
This patient desired a natural-looking nose, while also requiring functional improvements due to nasal congestion.
Using a closed (endonasal) approach, we were able to achieve both an aesthetically pleasing and healthy nose. Let me walk you through the process in detail.
1. Pre-Surgery Design Consultation
Let’s begin by analyzing the patient’s condition before the surgery:
Here are the pre-surgery design photos that helped guide the procedure:
Front View:
The nasal tip appears long, and the columella is drooping, giving the nose a "hooked" or "arrow-shaped" appearance.
Overall, the nose looks elongated, contributing to a disproportionate facial balance.
Asymmetry in the nostrils is noticeable, which further affects the overall harmony of the nose.
Side View:
A prominent dorsal hump (hump nose) is clearly visible, creating a convex profile.
The nose appears long from the side, with the tip drooping downwards, which emphasizes the elongated appearance.
The drooping nasal tip further contributes to an unbalanced nasal profile.
Left Angled Side View:
The dorsal hump becomes even more prominent in this view, drawing attention to the uneven contour of the nasal bridge.
The drooping of the nasal tip is clearly visible, making the overall shape of the nose less refined.
Here are the pre-operative design consultation photos: right lateral view, oblique view, and nasal base view.
Nasal Base:
Noticeable asymmetry in the nostrils.
The columella is slightly tilted to the right.
Additionally, the patient reported symptoms of nasal congestion. A CT scan performed at our clinic revealed the following findings:
Nasal septal deviation to the left.
Enlargement of the inferior turbinates on both sides.
Based on these results, the patient was diagnosed with septal deviation and hypertrophic rhinitis.
2.Surgical Plan
Taking into account the patient's condition and requests, we have established the following surgical plan:
a) Lateral osteotomy to prevent nasal widening after hump correction.
b) Septal extension graft using septal cartilage to correct drooping of the nasal tip.
c) Septoplasty to correct the deviated septum.
d) Submucosal resection of the inferior turbinates using radiofrequency laser to treat hypertrophic rhinitis.
e) Repositioning and suturing of the alar cartilages for tip refinement.
f) Nasolabial angle correction.
3.Surgical Procedure Details
All procedures were performed using a closed (endonasal) approach. The specific steps of the surgery are outlined below:
a) Lateral Osteotomy:
After refining the dorsal hump, a precise lateral osteotomy was performed to narrow the widened nasal bridge.
This technique allowed for a smoother, more natural contour of the nasal dorsum.
b) Septal Extension Graft:
The patient’s own septal cartilage was used to perform the septal extension graft.
This helped elevate the drooping nasal tip and adjust the overall length of the nose for improved facial harmony.
c) Septoplasty:
The deviated septum, which was skewed to the left, was corrected to improve nasal airflow and alleviate congestion.
Special attention was given to maintaining structural stability to ensure long-term, stable results.
d) Submucosal Resection of the Inferior Turbinates:
Using a radiofrequency laser, hypertrophied inferior turbinate tissue was reduced.
This enlarged the nasal airway and significantly improved breathing function.
e) Tip Refinement and Nasolabial Angle Adjustment:
The alar cartilages were repositioned and delicately reshaped and sutured to create a refined, natural nasal tip.
The nasolabial angle (the angle between the nose and the upper lip) was adjusted to enhance overall facial balance.
4.Before and After Surgery Photo Comparison
Upon reviewing the post-surgery photos, the following improvements can be observed:
Frontal view before surgery (left) after surgery (right)
The previously drooping nasal tip has been naturally shortened, eliminating the "hooked" appearance.
The nose, which previously appeared elongated, is now appropriately shortened, improving overall facial proportions.
The once bulbous nasal tip has been refined, resulting in a more natural and aesthetically pleasing shape.
45-degree angle view before surgery (left) after surgery (right)
The dorsal hump has been smoothly corrected, creating a soft and clean nasal contour.
The previously drooping nasal tip has been lifted, resulting in a more defined and elevated appearance.
The lowered columella has been naturally corrected, improving the nasolabial angle.
The overall length of the nose has been adjusted to achieve a balanced and harmonious look.
Side profile view before surgery (left) after surgery (right)
The prominent dorsal hump has been naturally corrected, resulting in a smoother profile.
The once bulbous and drooping nasal tip has been refined into a more delicate and feminine shape.
The overall nasal contour has become softer and more natural, enhancing facial harmony.
Nostrils before surgery (left) after surgery (right)
The asymmetry of the nostrils has been significantly improved.
The position of the columella has been corrected, enhancing the overall balance of the nose.
5.Post-Surgery Photo Collection
Photos taken immediately after surgery, frontal view, 45-angle view, and side profile.
Photo of the nostrils
Overview
This case represents a successful rhinoplasty for a patient presenting with a combination of issues: a long nose, a dorsal hump, and functional concerns. Using a closed approach, we were able to address all of these issues without leaving any external scars.
The most notable achievement in this case is the simultaneous improvement of both aesthetic and functional aspects. We corrected the dorsal hump and long nose, resulting in a more feminine and natural nasal shape, while also treating the septal deviation and hypertrophic rhinitis, which alleviated the patient's nasal congestion.
The hump correction via lateral osteotomy played a crucial role in creating a smoother nasal contour, which significantly softened the patient’s overall facial appearance. The septal extension graft helped lift the drooping nasal tip and adjust the overall nose length, achieving a balanced and harmonious profile.
The septoplasty and submucosal resection of the inferior turbinates went beyond cosmetic enhancement by significantly improving the patient’s quality of life. The relief from nasal obstruction will enhance daily comfort and positively impact other areas, such as sleep quality.
By opting for a closed approach, we minimized scarring and shortened the recovery period, providing a major benefit for the patient. Though this technique requires advanced skill and experience, it offers tremendous advantages in terms of patient outcomes.
Conclusion
I hope this case provides encouragement to those struggling with concerns about a long nose, a dorsal hump, or functional issues like nasal congestion. Rhinoplasty can bring about significant changes not only from a cosmetic standpoint but also in terms of functionality.
The key to a successful surgery lies in creating a customized surgical plan that takes into account each patient’s unique facial structure, desired outcome, and overall health. At Nose Lab Clinic, we leverage our extensive experience and expertise to offer tailored solutions that best suit each individual.
For anyone considering rhinoplasty, I strongly recommend consulting with a qualified specialist to determine the most appropriate surgical approach for you. If functional issues are present, consultation with an ENT specialist is especially crucial.
Through a comprehensive approach that simultaneously considers functional and cosmetic improvements, we aim to create beautiful noses that breathe easy.
With Noselab Clinic you can achieve a beautiful and healthy nose!
Thank you..
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