[Nose Lab Clinic]
Hello, this is Dr. Cha-Young Kang, Director of Nose Lab Clinic.
Today, I’d like to share a challenging nostril stenosis reconstruction case that resulted from multiple previous surgeries, including nostril reduction and philtrum shortening. This case highlights the importance of cautious surgical planning and the delicate approach required to correct nostril constriction while maintaining natural aesthetics and functional breathing.
1. Initial Assessment – Functional & Aesthetic Concerns
Design Consultation: Frontal View, Left Side View, and Oblique Side View Photos
a. Frontal View
🔹 Bulbous, wide nasal tip
🔹 Asymmetrical nostrils
🔹 Pinched nasal tip
🔹 Mildly deviated nasal bridge
Design Consultation: Right Side View, Oblique Side View, and Nostril View Photos
b. Nostril View
🔹 Significant nostril asymmetry
🔹 Collapsed left nostril due to prior nostril reduction
🔹 Leftward deviation of the columella
🔹 Internal scar tissue obstruction in the left nostril
2. Surgical Plan
✅ Reconstruct the septum and columella using autologous rib cartilage
✅ Correct the deviated bridge via lateral osteotomy
✅ Expand the collapsed nostril using local flap (rotation flap technique)
✅ Rebuild the nasal base to restore structural integrity
✅ Remove excessive internal scar tissue
✅ Adjust nasolabial angle for improved facial harmony
3. Surgical Execution & Key Procedures
a. Structural Reconstruction
🔹 Due to severe damage to the septal cartilage and weakened alar cartilage, autologous rib cartilage was used to rebuild both structures for long-term stability.
b. Tip & Nostril Refinement
🔹 Extensive scar tissue was carefully excised to eliminate contracture and nasal obstruction.
🔹 A rotation flap technique was used to expand the left nostril and improve overall symmetry.
c. Functional Nasal Correction
🔹 Left nasal valve collapse was repaired, significantly improving airflow.
🔹 A nasolabial angle adjustment corrected the subtle downward tilt of the nose, refining profile aesthetics.
4. Post-Surgical Outcomes
Before (Left) / Immediately After (Right)
a. Frontal View
✔ More balanced nostril symmetry
✔ Refined, natural nasal tip contour
✔ Straighter columella alignment
Before (Left) / Immediately After (Right)
b. Side Profile
✔ Nasal tip projection balanced with facial proportions
✔ Nasolabial angle adjusted for a softer, more feminine appearance
Before (Left) / Immediately After (Right)
c. Three-Quarter View
✔ Enhanced nasal structure without excessive pinching
✔ Harmonized dorsal aesthetic line
Before (Left) / Immediately After (Right)
d. Nostril Correction
✔ Improved left nostril opening, restoring symmetry
✔ Internal scar tissue successfully removed
✔ Stable, natural nasal base reconstruction
5. Expert Insights – The Challenges of Nostril Stenosis Repair
🔹 Why is Nostril Stenosis Difficult to Fix?
1️⃣ High Risk of Recurrence: If overcorrected, the nostril may collapse again due to excessive scar contracture.
2️⃣ Airway Compromise: Aggressive surgery can worsen breathing issues, requiring careful functional restoration.
3️⃣ Structural Limitations: Severe nostril constriction due to past reduction surgery can limit reconstructive options.
🔹 The Key to a Successful Nostril Reconstruction
✅ Minimal and precise excision of scar tissue
✅ Adequate structural support using autologous cartilage
✅ Natural contour restoration without overcorrecting
6. Final Thoughts & Patient Advice
Immediately After Surgery: Frontal, Side, and Oblique Side View Photos
Immediately After Surgery: Nostril View Photos
🔹 Be Cautious with Nostril Reduction Surgery!
Over-reducing the nostrils can lead to permanent structural and functional complications.
Patients considering nostril or philtrum reduction should consult experienced specialists to avoid irreversible complications.
🔹 If Complications Occur, Seek a Specialist
For patients experiencing nostril collapse or nasal breathing issues, revision surgery is possible, but requires meticulous planning and specialized surgical techniques.
At Nose Lab Clinic, we specialize in challenging revision rhinoplasty cases, prioritizing both functional and aesthetic outcomes.
Dr. Cha-Young Kang
Director, Nose Lab Clinic
Thank you.
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