Hello, this is Dr. Cha-Young Kang, Director of Nose Lab Clinic.
Today, I’ll share a case involving a patient who experienced nasal obstruction and an upturned nose following multiple surgeries. This case demonstrates how structural reconstruction using rib cartilage can deliver both functional and aesthetic improvements.
1. Surgical History
9 years ago: Ear cartilage + silicone implant
3–4 years ago: Nasal obstruction surgery + septoplasty + ear cartilage + silicone
2.5 years ago: Silicone removal
2. Key Symptoms and Patient Goals
Design Consultation: Frontal View, Left Side View, and Oblique Side View Photos
Severe nasal obstruction (worse on the right side)
Excessive nostril show
Upturned nasal tip
Desire for increased nasal height
Preference for rib cartilage over synthetic implants due to concerns about infection
Design Consultation: Right Side View, Oblique Side View, and Nostril View Photos
3. Preoperative Analysis
a. Frontal View
Before (Left) / Immediately After (Right)
Excessive nostril exposure
Asymmetrical nostrils
Wide nasal bridge
b. Side View
Before (Left) / Immediately After (Right)
Pronounced upturned nose
Large nasolabial angle
Prominent mouth projection
Low nasal dorsum
c. Oblique View
Before (Left) / Immediately After (Right)
Over-rotated nasal tip
Prominent mouth projection
d. Nostril View
Before (Left) / Immediately After (Right)
Asymmetrical nostrils
Deviated columella tilted to the left
4. Surgical Approach
The most significant intraoperative finding was the near-total loss of septal cartilage, leaving the nasal tip without structural support. To address this:
a. Structural Reconstruction
Full septal reconstruction using rib cartilage
Structural correction to reduce excessive nostril exposure
Nostril lowering surgery
b. Functional Improvements
Release of nasal adhesion
Internal nasal valve reconstruction
Septoplasty to correct septal deviation
Turbinate reduction using submucosal resection (to address nasal obstruction and rhinitis)
5. Postoperative Results
a. Structural Improvements
Stable nasal tip support
Reconstructed and functional septum
Harmonious nasal height
b. Aesthetic Enhancements
Reduced nostril show
Corrected upturned nasal tip
Smooth and natural nasal bridge
c. Functional Improvements
Straightened deviated septum
Resolved nasal adhesion
Reconstructed bilateral internal nasal valves
Reduced turbinate size, resulting in significant relief from nasal obstruction
Immediately After Surgery: Frontal, Side, and Oblique Side View Photos
Immediately After Surgery: Nostril View Photos
6. Specialist Insights
The highlight of this case was the complete reconstruction of the missing septal cartilage using rib cartilage. This not only restored structural integrity but also ensured long-term stability. The careful balance of functional and aesthetic corrections led to substantial improvements in both breathing and appearance.
For patients who have undergone multiple surgeries, personalized treatment plans and precise surgical techniques are essential to achieve optimal outcomes. Rib cartilage is particularly advantageous in such cases due to its durability and versatility.
7. Closing Remarks
At Nose Lab Clinic, we strive to deliver individualized care tailored to each patient’s unique needs. This case demonstrates how we address complex issues like nasal obstruction and structural deformities while achieving aesthetically pleasing results.
For those facing similar challenges, we hope this case provides insight and reassurance about the possibilities of modern rhinoplasty.
Thank you for reading. This is Dr. Cha-Young Kang, Director of Nose Lab Clinic.
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