[Nose Lab Clinic]
Hello, this is Dr. Cha-Young Kang from Nose Lab Clinic.
Today, I’d like to share a complex revision case where a patient with a history of multiple nasal surgeries presented with an upturned nose, columella retraction, pinched nasal tip, nostril asymmetry, and chronic rhinitis. This case required both functional and aesthetic correction to restore a natural and well-balanced nasal shape while addressing breathing difficulties.
Design Consultation: Frontal View, Left Side View, and Oblique Side View Photos
1. Patient’s Surgical History
12 years ago: Ear cartilage + silicone rhinoplasty
Same year: Columella retraction repair surgery
3 years ago: Revision due to an upturned nose, involving ear cartilage, silicone, alloderm on the left side, and alar base correction
Past 2 years: Chronic complications (suture dehiscence, repeated infections, multiple antibiotic treatments, hyperbaric oxygen therapy)
2. Primary Concerns
Design Consultation: Right Side View, Oblique Side View, and Nostril View Photos
Left-sided nasal obstruction
Chronic rhinitis with persistent nasal discharge
Severely upturned nasal tip
Columella retraction
Pinched nasal tip
Nostril asymmetry
Nasal Endoscopy Photos
3. Patient’s Requests
Correct the upturned nose
Restore columella projection
Resolve pinched nasal tip appearance
Improve nostril asymmetry
Reduce chronic rhinitis symptoms
Reference Images Desired by the Patient
4. Surgical Plan & Execution
a. Functional Improvements
Septoplasty for deviated septum correction
Submucosal turbinate reduction using high-frequency laser
Reinforcement of nasal airway structure if needed
b. Structural Corrections
Stabilization of the over-rotated (upturned) nasal tip
Columella lengthening using septal cartilage and alar cartilage grafting
Evaluation and repositioning of previous surgical materials
c. Aesthetic Refinements
Correction of pinched nasal tip
Enhancement of symmetry and balance
Creation of a natural and well-defined nasal contour
5. Surgical Outcomes
Before (Left) / Immediately After (Right)
a. Frontal View
Improved nasal symmetry
Refined nasal tip with enhanced definition
Correction of pinched nasal tip
Before (Left) / Immediately After (Right)
b. Side Profile
Stable and natural nasal tip positioning
Augmented columella for better proportion
Balanced nasolabial angle for a more harmonious profile
Before (Left) / Immediately After (Right)
c. Functional Improvements
Significant relief from nasal obstruction
Expected reduction in rhinitis symptoms
Improved nasal airflow and breathing efficiency
Before (Left) / Immediately After (Right)
6. Expert Insights
Immediately After Surgery: Frontal, Side, and Oblique Side View Photos
Immediately After Surgery: Nostril View Photos
This was a highly complex revision case due to multiple prior surgeries, chronic complications, and structural damage from previous procedures. Given the history of suture dehiscence, infections, and hyperbaric oxygen therapy, special attention was required to ensure proper wound healing and long-term stability.
By correcting the upturned nose, addressing columella retraction, refining the nasal tip, and improving nasal function, we were able to achieve a natural, proportional, and well-balanced outcome.
This case highlights the importance of carefully planned revision strategies and a meticulous approach to structural reinforcement and healing optimization.
This is Dr. Cha-Young Kang, Chief Surgeon at Nose Lab Clinic.
Thank you.
Comments