Why the nose looks crooked and the columella tilts to one side, and how to correct it

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

Today, I would like to share a detailed revision rhinoplasty case of a patient who was troubled by a crooked nose and columellar asymmetry.

• 10 years ago: Nasal filler procedure (previously dissolved)

• 8 years ago: Ear cartilage + silicone implant surgery

• 9 months ago: Autologous rib cartilage + silicone implant surgery

• Mobile silicone implant

• Residual foreign material in the left glabella

• Asymmetric nasal bones

• Crooked-appearing nasal bridge

• Columella tilted to the left

• Asymmetric columellar shape

• Correction of deviated nose

• Correction of the columella shape

• Resolution of the mobile silicone implant

Structural improvement

• Complete removal of residual foreign material in the left glabella

• Lateral osteotomy performed to correct asymmetric nasal bones

• Rightward shifting of septal cartilage to correct the columella (partial septal reconstruction)

• Septal reinforcement using autologous rib cartilage

• Removal of existing silicone implant

Improvement in shape

• Adjustment of glabella radix

• Creation of a natural line through nasolabial angle correction

• Correction of crooked nose

• Improvement in columellar symmetry

Front view

• Straightened crooked nose

• Balanced columella position

• Symmetric nasal shape

• Natural radix starting point

Profile view

• Harmonious nasal bridge line

• Stable nasal framework

• Natural nasolabial angle

• Aesthetically improved overall facial proportions

Nostrils

• Improvement of nostril asymmetry

• Improved columellar symmetry

• Leftward tilted columella properly straightened

• Balanced nostril shape

This was a complex revision rhinoplasty case for a patient who desired very precise correction. The primary focus was comprehensively resolving the problems resulting from multiple previous surgical procedures.

To correct the crooked appearance, residual foreign material in the left glabella was completely removed, and lateral osteotomy was performed to straighten the asymmetric nasal bones. To correct nostril asymmetry and the columella tilted to the left, partial septal reconstruction was performed by shifting the septal cartilage to the right, and the septum was reinforced sturdily using autologous rib cartilage.

In addition, considering the patient's overall facial proportions, the radix starting point was adjusted, and the nasolabial angle was corrected to achieve a natural, balanced line on profile view. By addressing the mobile silicone implant and securing a more stable structure, the crooked nose and columellar asymmetry that had troubled the patient for a long time were effectively improved.

This was a meaningful case in which meticulous attention to fine details enabled us to successfully achieve the natural, refined nasal shape the patient desired.

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

Thank you.

#closedrhinoplasty #revisionrhinoplasty #crookednosecorrection #columellacorrection #autologousribcartilage #customrhinoplasty