How to correct right-sided nasal obstruction, a bulbous tip, and an upturned nose

Hello. Today, I would like to introduce a surgical case correcting right-sided nasal obstruction along with a bulbous, upturned nose. In cases like this, patients often decide on surgery after multiple non-surgical treatments fail to deliver the desired results. I hope this post will be helpful to those with similar concerns.

Patient introduction

Patient profile

• Sex: Female

• Age: 31

• Occupation: Homemaker

• Primary concerns: Upturned nose, bulbous nose, right-sided nasal obstruction

Reason for choosing surgery

Patients presenting with this type have been stressed by an upturned nose with excessive nostril show, a bulbous and flared nasal tip, and right-sided nasal obstruction. She decided to undergo surgery wishing for narrower-looking alae and a natural nose.

First consultation with the patient

When I first met the patient, she had many worries due to complex feelings about the shape of her nose. In particular, an upturned nose with noticeable nostril show, a short and flared nasal tip, and right-sided nasal obstruction were major issues.

The patient's concerns and goals

The patient wanted a natural and refined nose. In particular, she wanted to prevent the nasal tip from spreading when smiling and improve the shape of the nasal bridge and nasal tip. She preferred keeping the nose from becoming elongated so that her midface would appear short, and she desired a straight bridge line. In addition, she hoped that her nose would not flare when smiling and that the tip would not point downward like an arrow nose.

Setting surgical goals

The patient's goals were as follows:

1. Bulbous nose correction: Refining the blunt nasal tip

2. Lateral osteotomy and silicone implant placement: Creating a slimmer appearance for a wide nasal bridge

3. Septal extension graft: Correcting the upturned nose for a natural appearance

4. Septoplasty: Improving right-sided nasal obstruction

5. Radiofrequency submucosal resection of the inferior turbinate: Improving right-sided nasal obstruction

Selecting the surgical approach

For the surgical approach, we chose septal extension, lateral osteotomy, silicone implant placement, septoplasty, and radiofrequency submucosal resection of the inferior turbinate. Through these procedures, we planned to create an overall natural and balanced nasal shape.

Septal extension and septoplasty

Through septal extension, we elevated the nasal tip and improved the bulbous tip shape. Through septoplasty, we widened the right nasal passage to relieve nasal obstruction.

Submucosal resection of the inferior turbinate

To relieve nasal obstruction, we performed submucosal resection of the inferior turbinate using radiofrequency.

Lateral osteotomy and silicone implant placement

To correct the wide nasal bridge, a lateral osteotomy was performed, and a silicone implant was inserted to achieve a slimmer appearance.

Front view comparison

In the preoperative front view, the short and wide appearance of the nose is noticeable. In the postoperative front view, the nose appears elongated and balanced.

Oblique view comparison

The oblique view highlights three-dimensional definition. While the nose appeared flat and wide before surgery, it gained natural and refined definition after surgery.

Profile view comparison

The profile view illustrates the septal extension graft and overall changes in nasal contour. Although the nasolabial angle appeared unnatural before surgery, it was adjusted to an appropriate angle after surgery.

Basal (nostril) view comparison

The asymmetry of the nostrils also showed noticeable improvement. While there was asymmetry between the left and right sides before surgery, balanced nostrils can be observed after surgery.

Through this surgery, the patient's nasal shape moved away from a short, flared look to become natural and well-balanced. When she initially visited, she requested a very natural result, but just before surgery, she noted that she did not want it to look too understated and preferred a prettier look even if it showed some definition. While we did not design an overly dramatic contour, we achieved a naturally defined balance. It may look slightly elevated during the recovery period—namely up to about 6 months—but from then on, it should settle into a natural yet slightly defined, attractive nose.

Closing remarks

I hope this post is helpful to those with similar concerns. For anyone concerned about their nasal shape, seeking professional consultation and surgery may help restore your confidence.

Frequently asked questions (FAQs)

1. How long is the recovery period after surgery?

Although recovery periods vary by individual, patients can generally return to daily activities in about 1-2 weeks.

2. Are cartilage grafts safe?

Yes, cartilage grafts are safe, and when autologous cartilage is used, the risk of rejection is minimal.

3. How is the pain after surgery?

There may be mild pain after surgery, but it can be managed with prescribed pain medication.

4. When can the surgical results be seen?

As swelling subsides, results gradually become visible after 1-2 months.

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