Revision rhinoplasty method to correct both an upturned nose and a crooked nose

Hello, I am Dr. Peter C. Kang.

Today, I would like to share a case where an upturned and artificial-looking nose

was corrected to achieve a natural appearance.

In cases of this type, the patient had previously undergone a first surgery using an L-shaped silicone implant,

and a second rhinoplasty using a silicone implant and ear cartilage.

1. Preoperative design consultation

Patient's requests:

- Correction of the artificial appearance

- Preference for a straight bridge line

- Lowering the radix

- Desire to lower the columella

- Desire to avoid lengthening the overall nose

Analysis of preoperative condition:

Front view:

- The nasal bridge appears crooked

- Excessive nostril show and asymmetry were observed

Oblique view:

- A curved ski-slope shape created an artificial appearance

- The nasal tip appears upturned

Profile view:

- The radix is high

- The nasal tip is upturned

- Protruding mouth was observed

Nostrils:

- The nasal tip was deviated to the right

- Nostril asymmetry was observed

2. Surgical plan

1) Septal extension using autologous rib cartilage

- Improvement of the upturned tip

- Correction of nostril asymmetry

2) Silicone implant replacement

- Removal of pre-existing implant

- Insertion of a shorter, lower, and wider new implant with a lowered radix

3) Lowering the columella and correcting the nasolabial angle

- Improvement of the elongated appearance of the philtrum

- Expected improvement in protruding mouth appearance

4) Functional improvement

- Correction of deviated septum

- Submucosal resection of the inferior turbinate using high-frequency radiofrequency (treatment for hypertrophic rhinitis)

3. Surgical procedure

According to the surgical plan, the following procedures were performed using a closed approach:

1) Autologous rib cartilage harvest and septal extension graft

2) Removal of the existing silicone implant and insertion of a new implant

3) Lowering the columella and correcting the nasolabial angle

4) Correction of the deviated septum

5) Submucosal resection of the inferior turbinate

4. Comparison of before-and-after photos

Front view:

- The previously deviated nasal bridge was straightened

- The previously upturned nasal tip was naturally lowered

- Nostril show and asymmetry were improved

Oblique view:

- The artificial curved ski-slope profile was changed to a natural straight bridge line

- The thin, artificial appearance of the bridge and tip was improved to a soft, natural contour

Profile view:

- The radix was lowered

- The previously upturned nasal tip was naturally lowered

- The columella was lowered, correcting the nasolabial angle

- Visible improvement in protruding mouth appearance

Nostrils:

- The deviation of the nasal tip was corrected

- Nostril asymmetry was significantly improved

5. Photos immediately after surgery on day 0 Photos taken immediately after surgery show swelling and may differ from the final result.

6. Overall evaluation

This case is a good example of transforming an artificial-looking nose into a natural contour.

In particular, changing the previous curved ski-slope profile to a straight bridge line

and naturally lowering the upturned tip improved the unnatural look.

Lowering the radix and the columella also improved the overall facial proportions.

Importantly, beyond aesthetic refinement, treating the deviated septum and hypertrophic rhinitis

achieved functional improvement at the same time.

This reflects the specialized expertise of a board-certified otolaryngologist.

7. Conclusion

While enhancing aesthetic appearance is essential in plastic surgery, if the beauty looks artificial,

one must keep in mind that such results do not remain satisfying over time.

From the initial design phase, natural harmony must always come first.

As demonstrated in this case, carefully considering each patient's facial anatomy and goals

is key to achieving a natural and aesthetically pleasing outcome.

I always prioritize the long-term satisfaction of patients

and pursue natural aesthetic balance.

If you are considering rhinoplasty, I encourage you to consult with a specialist

to find the most suitable and natural design for your features.

I will always strive to support the aesthetic and functional health of your nose.

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

Thank you.

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