Hello, this is Dr. Cha-Young Kang, Director of Nose Lab Clinic.
Today, I’d like to share the story of a patient who underwent multiple rhinoplasties, including an excessive nostril reduction surgery, and how we addressed the resulting complications through reconstructive surgery.
1. Surgical History
10 years ago: Bulbous tip correction, ear cartilage graft, silicone implant
6 years ago: Ear cartilage graft, silicone replacement, septal cartilage graft
3 years ago: Donor rib cartilage graft, silicone replacement, excessive nostril reduction surgery
Additional: Nasal obstruction surgery
Design Consultation: Frontal View, Left Side View, and Oblique Side View Photos
2. Key Symptoms and Patient Requests
Severe nasal obstruction, worse on the left side
Lower nasal starting point
A balanced, natural nose that doesn’t appear elongated
Soft, natural-looking nasal tip
Straight nasal dorsum (straight-line profile)
Improved symmetry
Lower columella for better nasolabial angle
Design Consultation: Right Side View, Oblique Side View, and Nostril View Photos
3. Preoperative Analysis
a. Frontal View:
Before (Left) / Immediately After (Right)
Blunt, undefined nasal tip
Crooked nose
Indistinct nasal tip contour
Overall unnatural appearance
b. Side View:
Before (Left) / Immediately After (Right)
No visible columella
Blunt, droopy tip
Poor nasal tip projection
c. Oblique View:
Before (Left) / Immediately After (Right)
Visible and irregular implant outline
Blunt, droopy tip
d. Nostril View:
Before (Left) / Immediately After (Right)
Severe scars from prior nostril reduction surgery
Asymmetrical nostrils
Contracted nostrils with limited size
Deviated columella to the left
4. Surgical Plan and Procedures
Structural Reconstruction:
Used autologous rib cartilage for septal extension and nasal framework support.
Aesthetic Refinement:
Lowered the columella to improve the nasolabial angle.
Removed excess scar and soft tissue to refine the blunt nasal tip.
Reconstructed the alar cartilages for natural tip definition and balance.
Functional Improvement:
Corrected the deviated septum to improve nasal airflow.
Addressed turbinate hypertrophy with turbinate reduction surgery for better breathing.
5. Postoperative Results
a. Frontal View:
Enhanced tip definition with natural contours.
Balanced and symmetrical nostrils.
b. Side View:
A naturally lowered nasal starting point.
Improved tip projection and columella positioning.
Corrected nasolabial angle, reducing the appearance of a protruding upper lip.
c. Oblique View:
Straight, refined nasal dorsum (straight-line profile).
Harmonized facial proportions with natural tip projection.
d. Nostril View:
Balanced nostril symmetry.
Straightened and stabilized columella.
Immediately After Surgery: Frontal, Side, and Oblique Side View Photos
Immediately After Surgery: Nostril View Photos
6. Specialist Insight and Closing Thoughts
This case demonstrates the complexities involved in reconstructive surgery following excessive nostril reduction. While we achieved an excellent outcome, the process was technically challenging and required careful planning and execution.
Key Takeaways on Nostril Reduction:
Avoid Overcorrection: Nostril reduction is a permanent change that’s difficult to reverse.
Minimize Extent: Any nostril reduction should be performed conservatively, with future potential complications in mind.
Bulbous Tips Require Caution: For patients with bulbous tips, nostril reduction should be a last resort, as it can worsen the aesthetic balance and functional issues.
At Nose Lab Clinic, we remain committed to finding the best solutions, even in complex cases, but prevention remains the best approach. If you are considering nostril reduction, I strongly encourage you to explore alternative options first and consult a specialist with extensive experience.
Thank you for reading. I hope this case provides insight and guidance for those facing similar challenges.This is Dr. Cha-Young Kang from Nose Lab Clinic.
Thank you.
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