Hello, I’m Dr. Cha-Young Kang, Director of Nose Lab Clinic.
Today, I’ll share the story of a 31-year-old male patient who underwent multiple nasal surgeries that left him with a longer, asymmetrical nose. This case highlights the importance of a tailored approach in rhinoplasty revision to achieve both functional and aesthetic harmony.
1. Patient History and Revision Background
2015: Initial surgery with silicone implant, nasal bone reduction, donated rib cartilage graft
2019: Nostril reduction
2023 (May): Silicone replacement, nasal bone reduction, additional rib cartilage graft
2023 (October): Additional revision due to nasal deviation
2024 (March): Implant-free surgery (SR technique) and nostril lift, with foreign material removal
Additional Treatments:
18 stem cell therapy sessions at other clinics before and after surgeries.
Design Consultation: Frontal View, Left Oblique Side View, and Side View Photos
Main Concerns:
Elongated nasal appearance
Crooked nose
Nostril and nasal asymmetry
High nasal starting point at the glabella (between the eyebrows)
2. Pre-Surgical Analysis
Design Consultation: Right Side View, Oblique Side View, and Nostril View Photos
Front View:
Broad nasal bridge
Asymmetrical nostrils and nasal wings
Nasal tip deviation toward the right
Side View:
High nasal starting point at the glabella
Excessively elongated nasal length
Sharp, prominent nasal tip
Collapsed columella (the bridge between nostrils)
Nostril View:
Tilted columella toward the right
Significant nostril asymmetry
3. Surgical Plan and Procedures
Given the complexity of this case, a comprehensive approach was essential for both structural and aesthetic improvement.
1. Structural Reconstruction:
Septal Extension with Autologous Rib Cartilage: Corrected nasal tip deviation and provided structural support.
Septal Deviation Correction: Addressed septal deviation for improved nasal airflow and straightened the nasal bridge.
Right Nasal Wing Reconstruction and Cartilage Graft: Restored symmetry and stability.
2. Asymmetry Correction:
Nostril Lowering on Right Side via Skin Graft: Improved nostril alignment.
Right Alar Lift Surgery: Corrected asymmetry of nasal wings.
3. Removal of Existing Foreign Materials:
Carefully removed rib cartilage particles previously placed in the nasal bridge and wings.
4. Adjustment of Nasal Starting Point at Glabella:
Bone Contouring: Sculpted the nasal bones for a smoother transition at the nasal bridge.
Soft Tissue Thinning: Adjusted the skin thickness for a lowered nasal starting point.
5. Finishing Touches:
Added a custom-carved, thin silicone implant for natural contouring and to smooth irregularities along the nasal bridge.
Before (Left) / Immediately After (Right)
Before (Left) / Immediately After (Right)
Before (Left) / Immediately After (Right)
Before (Left) / Immediately After (Right)
4. Surgical Outcomes
Front View:
Enhanced symmetry in nostrils and nasal wings.
Corrected nasal tip alignment for a straighter overall appearance.
Side View:
Smoothed nasal contour and reduced prominence at the nasal tip.
Lowered starting point of the nose for a more natural transition from the glabella.
Nostril View:
Improved nostril symmetry, with reduction in right-side tilt.
Balanced, natural columella and improved symmetry of nostril appearance.
Key Achievement: Lowered Nasal Starting Point at the Glabella
One of the most challenging aspects of this case was lowering the nasal starting point, as the patient had a prominent bridge from previous surgeries. By carefully thinning the soft tissue and refining the glabellar bone, we achieved a balanced and natural contour.
Conclusion
Repeated nasal surgeries often lead to a distorted or elongated appearance, especially when structural harmony is overlooked. Revision rhinoplasty in such cases requires a comprehensive approach that addresses both functionality and aesthetics to restore balance.
This case exemplifies the importance of a holistic, individualized approach to rhinoplasty revision. Nose Lab Clinic is committed to providing safe, customized solutions that address each patient’s unique needs. For those considering revision rhinoplasty, we encourage thorough consultations to determine the most appropriate surgical plan.
Thank you for reading. This is Dr. Cha-Young Kang, Director of Nose Lab Clinic.
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