Hello, this is Dr. Cha-Young Kang, head surgeon at Nose Lab Clinic.
Today, I would like to introduce a rhinoplasty case for a patient who had multiple aesthetic concerns, including an upturned nose, small nose, protruded lips, and nasal obstruction symptoms.
This case is a great example of achieving both functional improvement and aesthetic correction through the closed (endonasal) approach, highlighting the advantages of this technique.
Patient's Requests:
Prioritize functional surgery.
Achieve a straight nasal bridge.
Reduce nostril exposure.
Ensure natural-looking results.
Increase overall nose height.
1. Pre-Surgery Design Consultation
Let’s take a detailed look at the patient’s condition before surgery:
Pre-Surgery Design Consultation: Frontal, Left Oblique, and Left Profile Views
Frontal View:
Excessive Nostril Exposure
Low Glabella
Short and Wide Nose
Left Oblique View:
Protruded Lips
Upturned Nose
Flat Glabella
Profile View:
Noticeable Protruded Lips
Short and Upturned Nose
Flat Overall Appearance
Pre-Surgery Design Consultation: Right Oblique, Right Profile, and Nostril Views
Nostril View:
Wide and Flattened Nasal Tip
Compressed Nasal Tip
2. Surgical Plan
Based on the patient’s condition and specific requests, we developed the following surgical plan to address both functional and aesthetic concerns:
These are nasal endoscopy examination photos.
a) Septoplasty (Correction of Deviated Septum)
b) Submucosal Resection of the Inferior Turbinate Using Radiofrequency Laser
c) Septal Extension and Rhinoplasty Using Autologous Rib Cartilage
d) Lowering of the Columella and Nasolabial Angle Adjustment
e) Lateral Osteotomy
f) Dorsal Augmentation Using a Silicone Implant
3. Surgical Procedure
The surgery was performed using a closed (endonasal) approach, and the following steps were taken:
a) Septoplasty:
The deviated septal cartilage, which was shifted to the left, was corrected to improve nasal airflow and alleviate nasal congestion.
b) Submucosal Resection of the Inferior Turbinate:
High-frequency radiofrequency laser was used to reduce the enlarged inferior turbinate tissue, effectively improving symptoms of rhinitis.
c) Septal Rhinoplasty and Extension Using Autologous Rib Cartilage:
Rib cartilage was harvested from the patient and used to strengthen and extend the septum.
This corrected the upturned nasal tip and improved the overall nasal structure, providing better support.
d) Lowering of the Columella and Nasolabial Angle Adjustment:
Autologous rib cartilage was used to lower the columella, creating a more natural nasolabial angle.
This adjustment also helped to correct the appearance of a protruded upper lip.
e) Lateral Osteotomy:
Precise lateral osteotomy was performed to narrow the widened nasal bridge, creating a more refined and slender appearance.
f) Silicone Implant:
A silicone implant was carefully shaped and placed to create a straight line from the forehead to the nasal tip, enhancing the height and definition of the nasal bridge.
All procedures were completed using a closed approach, resulting in no visible external scars. This technique allowed for a comprehensive structural and cosmetic correction while maintaining a natural, scar-free outcome.
4. Before and After Photo Comparison
Upon reviewing the post-surgery photos, the following improvements can be observed:
Frontal view before surgery (left) after surgery (right)
Frontal View:
The excessive nostril exposure has significantly decreased, giving the nose a more balanced appearance.
The previously low glabella (area between the eyebrows) has been raised, resulting in a natural transition from the forehead to the nasal bridge.
The short and wide nose now appears longer and slimmer, providing a more refined facial profile.
45-degree angle view before surgery (left) after surgery (right)
Oblique View:
The protruded upper lip has been corrected, enhancing the overall facial balance and harmony.
The once upturned nose has been lowered to create a more natural and stable appearance.
The previously flat nose now has added definition, giving it a more three-dimensional and aesthetically pleasing look.
Side profile view before surgery (left) after surgery (right)
Profile View:
The correction of the protruded upper lip has improved the balance between the nose and lips, resulting in a more harmonious profile.
The short, upturned nose has been lengthened and lowered, improving the overall proportion and symmetry of the face.
The flat nasal bridge has been raised, providing natural height and depth, and enhancing the overall facial contours.
Nostrils before surgery (left) after surgery (right)
Nostril View:
The previously wide and flattened nasal tip has been refined, resulting in a more defined and balanced appearance.
The size and shape of the nostrils have been naturally corrected, contributing to a more symmetrical and aesthetically pleasing result.
5. After Surgery Table Photos
Photos taken immediately after surgery, frontal view, 45-angle view, and side profile.
Photo of the nostrils
6. Final Evaluation
This case exemplifies a comprehensive rhinoplasty that achieved both functional and aesthetic improvements. The septoplasty and turbinate reduction addressed the patient's primary concerns of nasal congestion and rhinitis, while cosmetic issues such as an upturned, short nose and protruded upper lip were corrected simultaneously.
The use of autologous rib cartilage in the septal rhinoplasty and septal extension was crucial in enhancing the structural stability of the nose and correcting the upturned nasal tip. This approach will likely contribute to long-term stability and satisfaction with the results.
Lowering the columella and adjusting the nasolabial angle not only improved the appearance of the protruded upper lip but also enhanced overall facial harmony. The lateral osteotomy and silicone implant successfully created the straight nasal line the patient desired, refining the bridge and improving the overall balance of the face.
Performing all of these procedures using a closed (endonasal) approach minimized scarring and accelerated the recovery process, showcasing Nose Lab Clinic’s specialized techniques. This case highlights our ability to address complex functional and cosmetic challenges while providing a natural and long-lasting result.
7. Closing Remarks
I hope this case provides encouragement to those struggling with both functional issues, such as nasal congestion, and aesthetic concerns. This example demonstrates that with the right surgical plan and techniques, it is possible to achieve improvements in both function and appearance.
At Nose Lab Clinic, we pride ourselves on our in-depth anatomical knowledge as ENT specialists and our extensive surgical experience, allowing us to provide personalized surgical plans tailored to each patient’s unique needs. If you are considering rhinoplasty, I encourage you to consult with a specialist to find the most suitable approach for your individual case.
We at Nose Lab Clinic are committed to helping you achieve a beautiful and healthy nose.
This has been Dr. Cha-Young Kang, head surgeon at Nose Lab Clinic.
Thank you.
Comments