Why nostril asymmetry and an upturned nose occur together, and how rib cartilage reconstruction works

Hello, I am Dr. Peter C. Kang.

Today, I would like to introduce the case of a patient whose severe nostril asymmetry and upturned nose were improved with autologous rib cartilage reconstruction.

• Previous surgery with septal extension + donor rib cartilage + silicone implant

• Deviated nose

• Upturned nose

• Leftward columellar deviation

• Severe nostril asymmetry

• Imbalance occurring without alar reduction

• Improvement of nostril asymmetry

• Crooked nose correction

• Correction of an upturned nose

• Desired a Hyun Bin-style nose

1. Structural improvement

• Lateral nasal bone osteotomy

• Correction of deviated septum

• Septal extension using autologous rib cartilage

2. Functional improvement

• Septoplasty

• Radiofrequency submucosal resection of the inferior turbinates

• Improvement of nasal obstruction

3. Shape improvement

• Correction of pinched right ala

• Adjustment of nasal tip position

• Correction of the deviated columella

Because there was significant intraoperative bleeding in this patient, overall swelling was relatively pronounced. Particularly in upturned nose correction, intraoperative bleeding can directly affect the early appearance. As the swelling subsides, the nasal tip is expected to settle a bit further down.

1. Front view improvement

• Improvement of crooked nose

• Balanced nostril symmetry

• More natural alar contours

2. Profile view improvement

• Stable tip position

• Refined into a straight line

• Correction of an upturned nose; the nasal tip is expected to settle further during future recovery

3. Nostril improvement

• Symmetric nostril shape

• Straightened columella

• Balanced overall structure

In this type of case, severe nostril asymmetry that developed without prior alar reduction was the primary target for improvement. Structural stability was established by combining septal extension using autologous rib cartilage with lateral osteotomy to correct the crooked nose. We were able to achieve the balanced nasal shape desired by the patient while also improving nasal function. In particular, although the patient experienced higher intraoperative blood pressure leading to heavier bleeding, the surgery was carried out smoothly using appropriate antihypertensive medications. However, when there is significant bleeding, more postoperative swelling is expected during recovery; because of this, the correction of the upturned appearance may look less pronounced in the early recovery period, but it is expected to improve further as swelling subsides.

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

Thank you.

#closedrhinoplasty #revisionrhinoplasty #autologousribcartilage #nostrilcorrection #customrhinoplasty