How to correct a bulbous, drooping nose

Hello.

I am Dr. Peter C. Kang, medical director.

Today, I would like to talk about corrective surgery for a bulbous, drooping nose.

A bulbous and drooping nose can be a source of cosmetic concern. Many patients desire a more refined and slender nose.

Let us look at the photos taken during the preoperative design consultation.

Preoperative design front view

On the front view, the presence of filler between the eyebrows causes spreading, and due to nasal bone asymmetry, the nose as a whole appears crooked and wide. The nasal tip looks bulbous and depressed, with a distinctly pinched appearance on the left ala and observable nostril asymmetry.

Preoperative design profile view

On the profile view, the radix starts unnaturally high, a small dorsal hump curvature is visible, and the nasal tip appears drooping.

Preoperative design oblique view

On the oblique view, there was not much height difference between the nasal tip and the glabella, making the nose appear overall long and flat, with a slight dorsal hump visible.

Photos of the nostrils are important for evaluating symmetry and balance. The left nostril was larger than the right, showing asymmetry.

To summarize, due to filler, this patient had a high radix, a small dorsal hump, and a crooked appearance from nasal bone asymmetry. The nasal tip looked bulbous and depressed, the left ala appeared pinched, and nostril asymmetry was also observed.

1. Design consultation: A nasal design that harmonizes with the facial shape is determined through consultation.

2. Nasal tip surgery: The nasal tip cartilage is reshaped for natural correction.

3. Filler removal and lateral osteotomy: The filler in the nasal bridge is completely removed, and nasal bone asymmetry is corrected using lateral osteotomy.

4. Silicone implant placement: A thin silicone implant is placed in the nasal bridge to elevate the bridge.

5. Septal extension: A portion of the septal cartilage is harvested to correct the nasal tip. If the septal cartilage is insufficient, donor rib cartilage is used to reinforce the nasal tip.

6. Partial subcutaneous tissue removal and alar cartilage suturing: Correction is achieved by reducing the thickness of the nasal tip skin.

7. Aftercare: Ongoing monitoring and consultations are provided to manage swelling and inflammation after correction.

Let us compare the before-and-after photos.

In the preoperative photos, a bulbous and drooping nasal tip, asymmetrical nostrils, and a crooked nasal bone were clearly visible. In the photo taken immediately after surgery, the bridge is elevated, the nasal tip is naturally projected, and nostril symmetry is aligned, resulting in an overall balanced appearance.

In particular, the bridge line, which previously drooped along a long profile, was improved so that the nasal tip looks smoothly, naturally defined and projected.

On the oblique view, the area where the nasal dorsum appeared elevated due to the dorsal hump was naturally corrected.

On the front view, the widened and elongated appearance was corrected, and the nose no longer looks crooked. The nasal tip shape has also changed much more naturally.

The nostril asymmetry has improved to the point where it is barely noticeable.

Through this corrective case, concerns regarding a bulbous and drooping nose were addressed, achieving a natural and balanced nasal shape. In particular, the improvement in the asymmetry of the nasal tip and nostrils brought out better facial three-dimensionality and harmony. I hope many patients can regain their confidence through satisfying corrective outcomes. I hope this provides helpful insight for those concerned about a bulbous and drooping nose.

This was Dr. Peter C. Kang. Thank you.