Why the nose turns up, the columella retracts, and the tip looks pinched: how composite correction is performed

Hello, I am Dr. Peter C. Kang.

Today, I would like to share the case of a patient who visited us to address multiple complex concerns and chronic rhinitis that developed after multiple surgeries.

• 12 years ago: Ear cartilage + silicone implant surgery

• Same year: Revision surgery for columellar correction due to columellar retraction

• 3 years ago: Due to an upturned nose, ear cartilage + silicone implant + donor dermis to the left pinched area + lower lateral cartilage correction

• For the following 2 years: Antibiotics, injections, and hyperbaric oxygen therapy due to suture dehiscence

• Left-sided nasal obstruction

• Chronic rhinitis

• Frequent rhinorrhea

• Upturned nose

• Retracted columella

• Pinched tip

• Nostril asymmetry

• Improvement of the upturned nose

• Correction of the retracted columella

• Correction of the pinched tip

• Improvement of asymmetry

• Relief of rhinitis symptoms

1. Functional improvement

• Septoplasty

• Radiofrequency submucosal resection of the inferior turbinate

• Septal reconstruction if needed

2. Structural improvement

• Stabilization of the upturned nose

• Analysis and reconstruction of the septal cartilage and lower lateral cartilage to correct columellar retraction

• Evaluation and adjustment of previous surgical materials

3. Shape improvement

• Correction of the pinched tip area

• Improvement of asymmetry

• Creation of a natural nasal profile

1. Front view

• Improvement of the crooked nose and better symmetry

• Natural tip contour and width

• Improvement of the pinched appearance

2. Profile view

• Stable tip position

• Reinforced columella and correction of the nasolabial angle

• Harmonious overall profile

3. Function

• Relief of nasal obstruction

• Expected relief of rhinitis symptoms

• Improvement in breathing function

This was a complex case with a history of multiple surgeries and treatment for inflammation. In particular, because the patient had an extensive history including oral antibiotics, injections, and hyperbaric oxygen therapy following suture dehiscence after a previous surgery, special attention was paid to the scar tissue and structural stability.

We were able to address several concerns simultaneously—including the upturned nose, retracted columella, pinched tip, and asymmetry—while also relieving chronic rhinitis symptoms. Especially because the patient had undergone extensive treatment for complications from prior surgeries, a meticulous approach was taken with safety and stability in mind.

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

Thank you.

#closedrhinoplasty #revisionrhinoplasty #upturnednosecorrection #retractedcolumella #customrhinoplasty