Why the columella droops severely into an arrow nose, and rib cartilage reconstruction methods

Hello, I am Dr. Peter C. Kang.

Today, I would like to introduce the case of a patient whose severe columellar drooping and long nose were improved through autologous rib cartilage reconstruction.

• 2019: Surgery with autologous rib cartilage and silicone implant

• 2024: Surgery with ear cartilage and silicone implant

1. Front view

• Severely drooping columella

• Arrow nose deformity

• Nostril asymmetry

• Pinched alae

2. Profile view

• Drooping tip

• Markedly lowered columella

• Acute nasolabial angle

• Protruding mouth findings

3. Nostrils

• Nostril asymmetry

• Columella deviated to the right

• Severe surgical scar on the columella

• Correction of nostril asymmetry

• Improvement of the long nose

• Improvement of the crooked nose

• Natural result

1. Structural reconstruction

• Harvesting autologous rib cartilage

• Performing septal extension

• Repositioning of lower lateral cartilage

2. Shape improvement

• Replacement of the nasal bridge implant

• Correction of the nasolabial angle

• Adjustment of high radix

3. Results

• Improvement of nostril asymmetry

• Improvement of drooping tip

• Improvement of protruding mouth

• Improvement in elongated appearance

1. Front view

• Improved columella position

• Natural nasal shape

• Improvement of nostril asymmetry

• Improvement of pinched alae

2. Profile view

• Improvement of tip drooping with an appropriate nasal tip position

• Correction of the nasolabial angle

• Improvement of protruding mouth

• Natural overall proportions

3. Nostrils

• Improvement of nostril asymmetry

• Correction of tilted columella

• More natural-looking columellar scar

This case presented a combination of severe columellar drooping, an arrow nose deformity, and nostril asymmetry. By harvesting autologous rib cartilage and performing septal extension, the position of the columella and the drooping of the nasal tip were effectively improved.

In particular, lower lateral cartilage repositioning corrected the nostril asymmetry, and nasolabial angle correction also improved the appearance of a protruding mouth. Lowering the radix slightly between the eyebrows naturally alleviated the elongated appearance of the nose.

The columellar scar from previous surgeries was also revised to make it as inconspicuous as possible, successfully achieving the natural result the patient desired.

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

Thank you.

#closedrhinoplasty #revisionrhinoplasty #autologousribcartilage #columellacorrection #customrhinoplasty