Why a dorsal hump can reappear and nostrils become visible after hump reduction

Hello, this is Dr. Peter C. Kang, medical director.

Today, I would like to introduce a revision rhinoplasty case of a patient presenting with excessive nostril show and a dorsal hump that had persisted for 17 years.

• 17 years ago: Dorsal hump shaving surgery

• 10 years ago: Nasal filler injection (removed on the day of surgery)

Front view

• Flared nasal shape

• Flat nasal bridge

• Deviated nose

• Excessive nostril show

Profile view

• Drooping tip

• Residual dorsal hump

• Wide nasolabial angle

• Elongated-looking philtrum

Nostrils

• Nostril asymmetry

• Columella tilted to the right

• Improvement of excessive nostril show

• Naturally elevating the nose

• Result harmonious with the face

Structural improvement

• Septal extension using autologous cartilage

• Complete removal of existing filler

• Correction of the nasolabial angle

Improvement in shape

• Repositioning the nasal tip to reduce excessive nostril show

• Correcting the nasolabial angle to improve the appearance of an elongated philtrum and an upturned look

• Creating a harmonious nasal bridge height

• Performing lateral osteotomies to correct the crooked nose

• Smoothing down the residual dorsal hump

Front view

• The crooked nose is corrected and straightened

• Excessive nostril show is naturally improved

• The previously flat and spread-out nasal contour has transformed into a well-balanced shape

• Overall natural impression

Profile view

• Naturally elevated nasal bridge

• Improved nasolabial angle

• The philtrum no longer appears elongated

• Dorsal hump reduction

Nostrils

• Nostril asymmetry is corrected

• The tilted columella is straightened

• Balanced nostril shape

This case presented complex concerns resulting from dorsal hump surgery 17 years prior and filler treatments 10 years ago. From the front view, the widened, flat nasal contour and excessive nostril show were evident; from the profile view, the drooping tip, obtuse nasolabial angle, and residual dorsal hump were the patient's primary concerns.

The primary focus was to improve the excessive nostril show and achieve a harmonious nasal bridge height. Lowering the nasal tip position effectively improved the excessive nostril show, while septal extension using autologous rib cartilage established a stable, well-balanced nasal framework. Additionally, lateral osteotomies were performed to correct the crooked nose, and completely removing the old filler before rebuilding the structure resolved the preexisting asymmetry.

To fulfill the patient's request for 'a result harmonious with the face,' the height and contour of the nose were carefully balanced with the patient's other facial proportions. Frontal nasal symmetry and nostril balance combined naturally with the harmonious profile height and refined nasolabial angle, improving the overall facial balance.

The residual dorsal hump and excessive nostril show were naturally improved, successfully achieving the look the patient desired without appearing artificial.

This has been Dr. Peter C. Kang, medical director.

Thank you.

#closedrhinoplasty #dorsalhumpcorrection #nostrilcorrection #revisionrhinoplasty #nasolabialanglecorrection #customrhinoplasty