Why nostril asymmetry and an upturned tip remain after alar reduction and how to correct them

Hello, I am Dr. Peter C. Kang.

Today, I will introduce a case where asymmetry and an upturned nose resulting from prior alar reduction surgery were corrected.

• 2014: Deviated septum + rhinitis + silicone implant + septal cartilage surgery (followed by tip revision)

• 2015: Nasal bridge + nasal tip + philtrum filler injection (dissolved after 3 years)

• 2018: Alar reduction surgery

• 2021: Philtrum reduction surgery

1. Front view

• Blunt nose

• Nose appearing crooked

• Nostril asymmetry

2. Profile view

• Upturned nasal tip

• Protruding mouth findings

• Irregular nasal bridge

• Appearance of a dorsal hump

3. Oblique view

• Protruding mouth findings

• Upturned nasal tip

• Bulbous nasal tip

4. Nostril view

• Nostril asymmetry caused by alar reduction surgery

• Distinct scarring around the alar region

• Rhinitis present

• Narrow right nasal cavity

• Improvement of drooping alae

• Correction of the silicone implant step-off

• Correction of deviated nose

• Improvement in nostril shape

• Improvement of alar contour

• Improvement of the nasolabial angle contour

• Inquiry regarding scar improvement from reduction surgery (not recommended due to the risk of worsening scars with additional incisions)

1. Structural improvement

• Reconstruction using autologous rib cartilage

• Correction of crooked nose

• Correction of the step-off by replacing with a new silicone implant

2. Shape improvement

• Refining a blunt nasal tip

• Improvement in nostril shape

• Repositioning of the drooping alae

3. Detailed adjustments

• Improvement of alar contour

• Correction of the nasolabial angle

• Adjustment of the nasal tip position to make scars less visible

1. Front view

• Improvement of crooked nose

• Balanced nostrils

• Refined nasal shape

2. Profile view

• Properly adjusted nasal tip position

• Smooth dorsal line

• Improved appearance of protruding mouth

3. Nostrils

• Improved nostril symmetry

• Adjusted alar contour

This case involved a history of multiple procedures, including alar reduction and philtrum reduction. In particular, correcting the asymmetry and prominent scars caused by the prior alar reduction was the main priority.

The patient inquired about scar revision, but I advised against it because additional incisions could make the scars more noticeable. Instead, the approach focused on making the existing scars as unobtrusive and natural as possible.

Through structural reconstruction using autologous rib cartilage, the crooked nose and upturned tip were corrected. Replacing the silicone implant resolved the step-off, and adjusting the nasolabial angle achieved overall facial harmony. Functional improvements were also accomplished, addressing both the narrow right nasal cavity and underlying rhinitis symptoms.

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

Thank you.

#closedrhinoplasty #revisionrhinoplasty #alarreduction #upturnednosecorrection #customrhinoplasty