Hello, this is Dr. Cha-Young Kang, Director of Nose Lab Clinic.
Today, I’m sharing the story of a patient who sought our help to address nasal congestion and asymmetry following an overly aggressive lateral osteotomy during a previous surgery. This case highlights the critical balance needed between aesthetics and functionality in rhinoplasty.
1. Patient History and Concerns
Surgical History:
2014: Closed hump nose correction + silicone implant + ear cartilage graft
2024: Silicone removal + ear cartilage graft + lateral osteotomy + hump and arrow nose correction
After the second surgery, the patient experienced severe nasal obstruction on the left side due to narrowed nasal passageways.
Patient Requests:
Restore structure compromised by over-aggressive lateral osteotomy
Address a broad nasal tip and low nasal height
Correct uneven surfaces and cartilage visibility
Achieve a natural straight-line contour without using implants
Fix a deviated nose
Design Consultation: Frontal View, Left Side View, and Oblique Side View Photos
2. Preoperative Assessment
Asymmetry: Left nasal bone collapse leading to a deviated and twisted nose.
Crooked Nose Caused by Left Nasal Bone Depression
Tip deformity: Broad and bulbous tip.
Dorsum: Irregular and bumpy dorsum with residual hump.
Residual Hump from Previous Surgery
Functional issues: Deviated septum to the left, left nasal valve collapse, and inferior turbinate hypertrophy confirmed by nasal obstruction tests.
Design Consultation: Right Side View, Oblique Side View, and Nostril View Photos
3. Surgical Plan
The surgery was designed to address both functional and structural issues comprehensively:
1. Functional Improvements:
Septoplasty: To correct septal deviation.
Radiofrequency turbinate reduction: To address turbinate hypertrophy.
Left internal nasal valve reconstruction: To restore airway space.
2. Structural Corrections:
Lateral osteotomy repair: Restore the collapsed left nasal bone by repositioning it laterally.
Hump correction: Smooth out residual dorsal irregularities.
Augmentation with rib cartilage: Elevate the dorsal profile without using implants.
3. Tip Refinement:
Columellar strut graft using rib cartilage: To support and define the nasal tip.
Scar tissue removal: To smoothen subcutaneous layers.
Alar cartilage repositioning and suturing: To narrow and reshape the nasal tip.
4. Surgical Outcomes
1. Front View:
Significant improvement in left nasal bone collapse.
Straightened and symmetrical nose.
Refined nasal tip with improved proportions.
Before (Left) / Immediately After (Right)
2. Side View:
Natural dorsal height with a smooth contour.
Complete correction of the residual hump.
Before (Left) / Immediately After (Right)
Before (Left) / Immediately After (Right)
3. Functional Results:
Restored nasal airflow on the left side.
Resolved nasal obstruction caused by internal valve collapse.
Before (Left) / Immediately After (Right)
5. Expert Insights
Aggressive lateral osteotomy can cause more than cosmetic dissatisfaction; it often leads to functional impairment such as nasal valve collapse and severe obstruction. Addressing these issues requires a dual approach:
Structural Restoration: Properly repositioning and reinforcing nasal bones and cartilage.
Functional Repair: Rebuilding internal nasal valves and ensuring airway patency.
This case highlights the importance of meticulous planning and execution in revision surgeries to achieve both functional relief and aesthetic harmony.
6. Conclusion
Immediately After Surgery: Frontal, Oblique Side, and Side Views
Immediately After Surgery: Nostril View Photos
At Nose Lab Clinic, we prioritize holistic solutions that address not only cosmetic desires but also functional needs. Complex revision cases like this demonstrate the importance of a careful and tailored approach to deliver natural, long-lasting results.
If you’re experiencing complications from previous rhinoplasty, we encourage you to consult with experienced specialists who understand the nuances of revision surgery.
Thank you for reading. This is Dr. Cha-Young Kang from Nose Lab Clinic.
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