Hello, this is Dr. Cha-Young Kang, head surgeon at Nose Lab Clinic.
Today, I would like to introduce a rhinoplasty case involving a patient who was concerned about their flat nose and desired a high, striking nose. The patient experienced a remarkable transformation through a customized rhinoplasty using autologous rib cartilage.
1. Pre-Surgery Design Consultation
We first conducted a detailed analysis of the patient's pre-surgery condition:
Pre-Surgery Design Consultation: Frontal View, Left Oblique Side View, and Side View
Frontal View:
The nose appeared flat overall.
The nasal tip was bulbous and wide.
The nose looked slightly long.
Oblique View:
The nasal bridge was bumpy.
The overall appearance of the nose was flat and long.
Side View:
The bumpy texture of the nasal bridge was more noticeable.
The patient had a prominent upper lip, which made the nose appear even flatter.
Pre-Surgery Design Consultation: Right Oblique Side View, Side View, and Nostril Photos
Nostril View:
There was nostril asymmetry.
The nose appeared wide and bulbous.
Patient’s Primary Requests:
A higher nose.
A more refined and striking overall appearance.
2. Surgical Plan
Considering the patient’s condition and requests, we devised the following surgical plan:
a) Septal extension graft using autologous rib cartilage.
b) Nasal tip augmentation and refinement.
c) Dorsal augmentation to increase the height of the nasal bridge.
d) Lateral osteotomy to narrow the wide nasal bridge.
3. Surgical Procedure
The surgery was performed using a closed (endonasal) approach for minimal scarring:
a) Harvesting Autologous Rib Cartilage:
We harvested the patient’s rib cartilage to secure enough cartilage for the procedure.
b) Septal Deviation Correction and Septal Extension Graft:
The patient had a deviated septum, which we corrected.
We extended and strengthened the septum using autologous rib cartilage to improve the support of the nasal tip and prevent future deviation.
c) Nasal Tip Augmentation and Refinement:
The nasal tip was raised using rib cartilage within a safe range to avoid complications.
The wide nasal tip was refined for a more delicate and sculpted appearance.
d) Dorsal Augmentation:
Rib cartilage was used to naturally raise the nasal bridge and smooth out the bumpy areas.
This improved the overall contour and enhanced the definition of the nose.
e) Lateral Osteotomy:
We narrowed the nasal bridge through a lateral osteotomy, improving the overall shape and symmetry of the nose.
Surgical Precautions:
The nasal tip skin was not excessively stretched to avoid complications such as tip deviation, redness, or cartilage visibility.
The height of the nasal tip was limited to within 90% of the maximum safe range, ensuring safe healing and natural results.
4. Before and After Photo Comparison
Comparing the photos immediately after surgery, the following improvements can be observed:
Frontal view before surgery (left) after surgery (right)
Frontal View:
The previously flat nose now has significant definition and structure.
The wide nasal tip has been refined, creating a more delicate and elevated look.
The overall length of the nose has been appropriately adjusted, resulting in a more balanced and harmonious appearance.
45-degree angle view before surgery (left) after surgery (right)
Oblique View:
The bumpy nasal bridge has been smoothed, creating a seamless and elegant line.
The height of the nose has been increased, giving a more striking and three-dimensional appearance.
The previously flat and long nose now has an ideal height and length, enhancing facial balance.
Side profile view before surgery (left) after surgery (right)
Side View:
The irregularities in the nasal bridge have been corrected, forming a smooth S-line.
The increased height of the nose has reduced the prominence of the upper lip, creating a more harmonious balance between the nose and the rest of the face.
The nose now forms a cohesive line from the bridge to the tip, resulting in a more sophisticated profile.
Nostrils before surgery (left) after surgery (right)
Nostril View:
The asymmetry in the nostrils has been corrected, achieving better symmetry.
The previously wide and bulbous nasal tip now appears more refined and sculpted.
The size and shape of the nostrils have been adjusted to create a more natural and proportional look.
5. Collection of Photos Immediately After Surgery
Photos taken immediately after surgery, frontal view, 45-angle view, and side profile.
Photo of the nostrils
6. Final Evaluation
This case showcases how a flat and low nose was transformed into a more defined and elevated nose using autologous rib cartilage. While fulfilling the patient’s desire for a higher and more striking nose, we paid careful attention to maintaining natural results.
Key areas of focus during this surgery included:
Correction of Septal Deviation: To prevent future curvature issues when raising the nasal tip, we first corrected the deviated septum. This step was crucial in ensuring the structural stability of the nose.
Safe Height Increase: The nasal tip skin’s size was carefully considered to achieve the maximum height while avoiding complications. By limiting the height increase to within 90% of the maximum safe range, we minimized the risk of side effects like tip deviation or redness.
Harmonious Line Formation: We ensured that the transition from the bridge to the tip was smooth and natural. This created a balanced look, giving the patient a striking yet natural result.
Improvement of Irregular Nasal Bridge: By using autologous rib cartilage, we corrected the previously bumpy nasal bridge, creating a smooth and refined contour.
Correction of Nostril Asymmetry: The size and shape of the nostrils were adjusted to improve symmetry and achieve a balanced appearance.
The use of autologous rib cartilage was a key feature of this surgery. Rib cartilage provides enough volume to be used in various areas of rhinoplasty, and since it is the patient’s own tissue, there is a lower risk of rejection and it offers long-term stability.
Additionally, the use of a closed (endonasal) approach minimized scarring, which contributed to a quicker recovery and a more natural post-surgery appearance.
7. Closing Remarks
I hope this case provides hope to those concerned with flat or low noses. Rhinoplasty is not just about raising the nose but about creating a nose that complements and enhances the overall balance of the face. It is essential to design a nose that fits each person’s unique facial structure and aesthetic preferences.
At Nose Lab Clinic, we always take into account the individual facial features and desires of each patient to create the most optimal surgical plan. Our commitment is to provide safe and satisfying results based on extensive experience and expertise.
If you are considering rhinoplasty, we encourage you to consult with a specialist to find the most suitable method for your unique needs. Nose Lab Clinic is dedicated to helping you achieve a beautiful and healthy nose.
Thank you.
This has been Dr. Cha-Young Kang, head surgeon at Nose Lab Clinic.
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