Hello, this is Dr. Cha-Young Kang, Director of Nose Lab Clinic.
Today, I’ll discuss an important case involving rhinoplasty for a deviated, upturned nose. This case includes nostril lowering, which can be particularly beneficial for those seeking a more natural, balanced nasal appearance.
Pre-Surgery Design Consultation Photos
Pre-Surgery Design Consultation Photos
1. Surgical History and Patient Goals
Surgical History:
2020: Initial correction of deviated nose using ear cartilage and silicone implant
2023: Additional tip surgery using pig cartilage
Current Condition and Goals:
Correction of nasal deviation
Lowering the tip to reduce visible nostril exposure
Maintaining the current bridge height
Resolving nasal obstruction
Surgical Plan
To address these goals, we designed a comprehensive surgical approach:
Septal Extension Graft: Using donor rib cartilage to stabilize and lengthen the septum
Septal Reconstruction (if necessary): For structural reinforcement
Nostril Lowering: Adjusting the tip position and reshaping the nostrils
Nasolabial Angle Adjustment: To soften the angle between the nose and upper lip
Mucosal Adhesion Release: To alleviate nasal obstruction
Adhesion Observed Between the Left Septal Mucosa and Inferior Turbinate (Arrow)
2. Pre-Surgical Analysis
Front View: The tip deviated to the left, with visible nostril asymmetry and a high nasion (bridge starting point).
Side View: The nasal tip was elevated, creating a larger nasolabial angle and giving the tip a pointed appearance.
Nostril View: The columella tilted left, resulting in significant asymmetry.
Before Surgery (Left) / Immediately After Surgery (Right)
Before Surgery (Left) / Immediately After Surgery (Right)
Before Surgery (Left) / Immediately After Surgery (Right)
Before Surgery (Left) / Immediately After Surgery (Right)
3. Post-Surgical Changes
Front View: The nasal tip was realigned to a centered position, reducing nostril visibility and correcting asymmetry. The bridge’s starting point was adjusted to a more natural position.
Side View: The starting point of the bridge was lowered, and the elevated tip was brought down, achieving a balanced nasolabial angle. The nasal tip now appears naturally rounded.
Nostril View: The columella was straightened, greatly improving nostril symmetry.
4.Conclusion
For patients with significant septal cartilage damage from previous surgeries, septal reconstruction is essential to achieve stable, centered alignment of the nose. Without this foundational correction, repeated surgeries may not fully resolve the deviation or asymmetry
If septal reconstruction is necessary, I strongly recommend seeking an experienced ENT specialist for optimal results. I hope this case provides helpful insights for those facing similar challenges.
Thank you,
Dr. Cha-Young Kang, Director of Nose Lab Clinic
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