Corrective approaches for nasal obstruction and asymmetry after lateral osteotomy

Hello, I am Dr. Peter C. Kang.

Today, I would like to share the case of a patient who visited our clinic with concerns about nasal obstruction and asymmetry that developed after previous surgeries.

• 2014: Closed rhinoplasty for dorsal hump + silicone implant + ear cartilage

• 2024: Silicone implant removal + ear cartilage + lateral osteotomy + dorsal hump correction + drooping tip correction

• Worsened left-sided nasal obstruction and narrowing of the nasal airway after the second surgery

• Reconstruction of excessive lateral osteotomy

• Improvement of a wide nasal shape and low height

• Correction of surface irregularities and implant visibility

• Desire for implant-free rhinoplasty

• Correction of crooked nose

• A natural straight bridge line

• Nasal bone asymmetry and a crooked nose due to left nasal bone depression

Deviated nose resulting from left nasal bone depression

• Blunt and broad nasal tip

• Irregular nasal bridge, dorsal hump

Residual dorsal hump under-corrected during the previous surgery

• Examination for nasal obstruction revealed leftward deviation of the septal cartilage, left nasal valve stenosis, and inferior turbinate hypertrophy

1. Functional surgery to improve nasal obstruction

   • Septoplasty

   • Radiofrequency submucosal resection of the inferior turbinates

   • Left internal nasal valve reconstruction

2. Structural correction

   • Lateral mobilization of the depressed left nasal bone (lateral osteotomy reconstruction)

   • Additional dorsal hump correction

   • Dorsal augmentation using autologous rib cartilage

3. Nasal tip improvement

   • Septal extension using autologous rib cartilage

   • Subcutaneous scar tissue removal

   • Lower lateral cartilage repositioning and suturing

1. Front view

• • Improvement of left nasal bone depression

  • Correction of crooked nose

  • Refinement of the bulbous nasal tip

2. Profile view

• • Creation of a natural dorsal height

  • Correction of the dorsal hump

Excessive lateral osteotomy can cause serious functional issues beyond simple cosmetic concerns. When the nasal bone is depressed, the upper lateral cartilage collapses, leading to nasal valve stenosis and significant nasal obstruction.

In these situations, rather than simple adjustment, nasal bone reconstruction must be performed alongside internal nasal valve reconstruction. In this case as well, proceeding with structural reconstruction and functional improvement at the same time helped resolve the patient's concerns.

I will continue to do my best to address both functional and cosmetic concerns simultaneously for our patients.

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

Thank you.

#closedrhinoplasty #closedrevisionrhinoplasty #closednasalobstructionsurgery #closedfunctionalrhinoplasty #revisionrhinoplasty #excessiveosteotomy #lateralosteotomyreconstruction #nasalobstructionrelief #nasalvalvereconstruction #autologousribcartilagegraft #implantfreerhinoplasty #functionalnasalsurgery #rhinoplastyrevision