How to reconstruct a pinched and upturned nose using autologous rib cartilage

Hello, I am Dr. Peter C. Kang.

Today, I would like to introduce a case where we corrected an upturned nose and a pinched nose that occurred after multiple surgeries.

• 1991: Silicone implant surgery

• August 2020: Silicone implant + donor rib cartilage

• January 2021: Revision rhinoplasty for height adjustment

• 2022: Philtrum reduction surgery

• Correction of an upturned and pinched nose

• A natural yet defined straight-subtle curve line

1. Front view

   • Appears upturned

   • Pinched appearance of the alae

   • Nasal bridge is crooked

   • Nostril asymmetry

2. Profile view

   • Drooping tip

   • Dorsal hump

   • Appears short

3. Nostrils

   • Nostril asymmetry

   • Columella tilted to the left

   • Pinched alae

1. Lateral osteotomy (correction of crooked nose)

2. Septal reconstruction using autologous rib cartilage

3. Lower lateral cartilage reconstruction (correction of pinched nose)

4. Septal extension (correction of short and upturned nose)

5. Nostril rim elongation (correction of upturned nose and nostril asymmetry)

6. Replacement of bridge silicone implant (overall height increase and straight-subtle curve line)

7. Nasolabial angle correction (improvement of protruding mouth)

8. Paranasal augmentation (improvement of nasolabial folds and protruding mouth)

9. Stem cell injection therapy (skin expansion, improvement of pinched and short nose)

10. Forehead foreign material removal and autologous fat grafting (for a natural forehead line)

1. Septal reconstruction

   • Reconstruction of the damaged septal cartilage using autologous rib cartilage

2. Alar reconstruction

   • Reconstruction of severely damaged bilateral lower lateral cartilages

   • Improvement of pinched alae through dermal grafting

3. Additional procedures

   • Improvement of nasolabial folds and protruding mouth through paranasal augmentation

   • Natural forehead contouring through autologous fat grafting following foreign material removal

[Set of 4 photos immediately after surgery on Day 0] Immediate postoperative photos show swelling and may differ from the final result.

1. Front view changes

   • Natural correction of areas that appeared upturned and pinched

   • Improvement of visible deviation

   • Enhanced nostril symmetry

   • Formation of an overall straight and aligned line

2. Profile view changes

   • Dorsal hump reduction

   • Correction of a drooping tip

   • Establishment of a natural straight-subtle curve line

   • Balanced lateral silhouette achieved through nasolabial angle correction

3. Nostril improvement

   • Resolution of the pinched alar appearance

   • Improving bilateral nostril symmetry

   • Correction of columellar deviation

   • Creation of natural alar curvature

4. Overall restorative results

   • Achieved a natural yet defined aesthetic look

   • Harmonious balance with overall facial features

   • Established a stable structural framework to help prevent long-term shape deformation

A nose that had become unnatural from multiple previous surgeries was revised into a natural yet refined straight-subtle curve line. Notably, the crucial aspect of this surgery lay not merely in surface cosmetic correction, but in fundamental structural reconstruction.

Using autologous rib cartilage, we solidly reconstructed the septum and lower lateral cartilages that had been damaged over multiple operations. This went beyond changing the visible contour; it was a foundational reinforcement of the structural framework. Building such a solid foundation minimizes future risk of deformation and provides the support needed to maintain a stable result over time.

Rhinoplasty is more than simple aesthetic enhancement; it is a procedure requiring thorough understanding of anatomical structures and meticulous reconstruction built upon that knowledge. NOSELAB will continue to do our utmost for the health and aesthetic satisfaction of our patients.

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

Thank you.

#revisionrhinoplasty #pinchednosecorrection #upturnednosecorrection #autologousribcartilage #nasalreconstruction #straightsubtlecurveline #paranasalaugmentation #alarreconstruction #closedrhinoplasty #stemcelltherapy