Why post-nasal drip and a drooping tip occur together, and how septal extension and functional surgery address them

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

Today, I would like to introduce a complex revision rhinoplasty case of a patient who had various functional and aesthetic concerns, including post-nasal drip, a drooping tip, a rounded nasal tip, and columellar width.

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

• 11 years ago: Septal cartilage and silicone implant surgery

• 6 months ago: Additional ear cartilage grafting surgery

Functional issues

• Post-nasal drip symptoms (sensation of drainage down the throat)

• Breathing discomfort

Front view

• Crooked-looking nasal line

• Wide-looking alae

• Flared-looking nasal tip

• Narrow columellar width

• Nostril asymmetry

• Excessive nostril show

Profile view

• Drooping nasal tip

• High radix

• Philtrum appears long

• Wide nasolabial angle

Nostrils

• Nostril asymmetry

• Columella tilted to the left

• Reduction of nostril show

• Improvement of the flared-looking nasal tip

• Reduction in alar size

• Lowering the glabella radix

• Improvement in nostril shape

• Improvement so the philtrum does not appear long

Structural improvement

• Septal extension using autologous cartilage

• Repositioning of existing nasal structures

• Correction of the nasolabial angle

• Two procedures to improve nasal function (septal and turbinate surgery)

Improvement in shape

• Improvement of balance through alar reduction

• Lowered glabella radix

• Refinement of the nasal tip shape

• Optimization of philtrum length

Functional improvement

• Improvement of post-nasal drip symptoms

• Improvement of nasal obstruction

Before surgery / Day 0 immediately after surgery Photos taken immediately after surgery show swelling and may differ from the final result.

Front view

• Correction of the crooked-looking nasal line

• Improvement in nasal tip shape

• Widened columella width

• Reduced nostril show

Before surgery / Day 0 immediately after surgery Photos taken immediately after surgery show swelling and may differ from the final result.

Profile view

• Correction of the drooping tip

• Balanced nasal line

• Lowered glabella radix

• Improved philtrum length

• Appropriate nasolabial angle

Before surgery / Day 0 immediately after surgery Photos taken immediately after surgery show swelling and may differ from the final result.

Nostrils

• Balanced nostril shape

• Improvement of nostril asymmetry

• Improvement of the tilted columella

Before surgery / Day 0 immediately after surgery Photos taken immediately after surgery show swelling and may differ from the final result.

This patient had a history of multiple surgeries and presented with complex issues accompanied by post-nasal drip (the sensation of secretions draining down the throat). It was an intricate case requiring aesthetic refinement in multiple areas, such as a drooping tip, a flared-looking nasal tip, a narrow columella width, alar size, and nostril show, alongside functional post-nasal drip symptoms.

To address these multifaceted issues, a septal extension using autologous cartilage was performed to correct the drooping tip, and the tilted columella was straightened to secure a stable supportive framework. In particular, widening the columellar width helped enhance the stability of the nasal tip and reduce nostril show.

The flared-looking nasal tip was refined into a more defined shape through precise repositioning of the cartilages. Furthermore, in accordance with the patient's requests, the radix was lowered and the nasolabial angle was adjusted, thereby improving the appearance of an elongated philtrum.

From a functional standpoint, septal surgery and inferior turbinate surgery (rhinitis surgery) were performed together to address the post-nasal drip, effectively relieving the uncomfortable sensation of drainage down the throat. Through this combined functional and aesthetic approach, a harmonious outcome reflecting the patient's diverse concerns was achieved.

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

Thank you.

#closedrhinoplasty #revisionrhinoplasty #postnasaldripimprovement #columellawidening #customrhinoplasty