[Nose Lab Clinic]
Hello, this is Dr. Cha-Young Kang, Director of Nose Lab Clinic.
Today, I’d like to share a case of reconstructive surgery following multiple nasal procedures, including overly aggressive alar base reduction. This case demonstrates how we achieved an optimal balance despite significant challenges.
1. Surgical History
10 years ago: Bulbous nose correction, ear cartilage graft, and silicone implant.
6 years ago: Additional ear cartilage and silicone implant, along with septoplasty.
3 years ago: Rib cartilage graft, silicone implant, and alar base reduction.
Previous rhinitis surgery.
Design Consultation: Frontal View, Left Side View, and Oblique Side View Photos
2. Primary Symptoms and Patient Goals
Severe nasal obstruction, more pronounced on the left side.
Desire for a lower nasal starting point.
Correction of a short and unnatural nose.
Natural-looking nasal tip without excessive sharpness.
Creation of a straight nasal line.
Improvement of asymmetry.
Lengthening of the columella for better proportions.
Design Consultation: Right Side View, Oblique Side View, and Nostril View Photos
3. Preoperative Analysis
a. Frontal View
Blunt and bulbous nasal tip.
Crooked nose.
Poor nasal tip definition.
Unnatural overall nasal shape.
Before (Left) / Immediately After (Right)
b. Side View
Lack of visible columella.
Blunt nasal tip.
Unnatural nasal projection.
Before (Left) / Immediately After (Right)
c. Oblique View
Prominent implant contours.
Blunt and drooping nasal tip.
Lack of refinement in nasal contour.
Before (Left) / Immediately After (Right)
d. Nostril View
Significant scarring from prior alar base reduction.
Asymmetrical nostrils.
Reduced nostril size.
Deviated columella towards the left side.
Before (Left) / Immediately After (Right)
4. Surgical Approach
a. Structural Reconstruction
Lengthened the columella using autologous rib cartilage.
Lowered and adjusted the columella to achieve a balanced nasolabial angle.
Removed scar tissue and reconstructed the nasal tip for a natural appearance.
b. Nasal Tip Refinement
Removed excess subcutaneous and scar tissue to reduce nasal tip bulkiness.
Repositioned and sutured the alar cartilages to enhance definition and symmetry.
c. Alar Base and Nostril Correction
Rebuilt the alar base to restore balance and functionality.
Corrected asymmetrical nostrils.
d. Functional Improvements
Septoplasty to correct the deviated septum.
Surgery for rhinitis and nasal obstruction relief.
5. Results
a. Frontal View Improvements
Sharper, more defined nasal tip.
Balanced and symmetrical alar base.
Corrected nasal asymmetry.
b. Side View Enhancements
Lowered and naturalized nasal starting point.
Corrected columella visibility.
Harmonious and straight nasal profile.
c. Oblique View Changes
Smoother and more refined nasal contour.
Elimination of visible implant irregularities.
d. Nostril View Refinement
Restored balance to nostril size and shape.
Corrected columella deviation for a more symmetrical appearance.
Immediately After Surgery: Frontal, Oblique Side, and Side View Photos
Immediately After Surgery: Nostril View Photos
6. Expert Insights & Takeaways
This case underscores the complexities involved in reconstructive surgery following overly aggressive alar base reduction. A few key lessons:
Alar base reduction should be approached cautiously.
Once reduced, it is difficult to reverse, and aggressive reduction often leads to permanent structural and functional challenges.
Reconstruction requires meticulous planning.
Combining autologous tissue with advanced techniques ensures both functional stability and aesthetic harmony.
Prevention is paramount.
As I always emphasize, unnecessary alar base reduction should be avoided. If performed, it should be limited to the minimal extent necessary to achieve the desired outcome.
Closing Thoughts
At Nose Lab Clinic, we strive to deliver the best outcomes, even in the most challenging cases. This case highlights the importance of comprehensive planning and precise execution to restore both functionality and aesthetics.
Thank you for reading. This has been Dr. Cha-Young Kang, Director of Nose Lab Clinic.
Feel free to contact us for a consultation or more information about our approach to revision rhinoplasty and reconstructive surgery.
Best regards,
Dr. Cha-Young Kang
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