Why bulbous noses are difficult to correct and the reconstruction method after foreign material removal

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

Today, I would like to share a case where a natural nasal line was achieved through bulbous nose correction and the removal of foreign material from previous procedures.

• 2020: Nasal filler procedure

• 2023: Nasal thread-lifting procedure

Characteristics

• Blunt, bulbous nose

• Presumed residual nasal filler and threads from previous procedures

• Irregular nasal line

• Drooping nasal tip

• Nostril asymmetry

• Bulbous nose correction

• Natural nasal line

• Removal of foreign material from previous procedures

• Open to a subtle dorsal hump contour

Consultation process

• Initially preferred implant-free rhinoplasty

• Explained that correcting a bulbous nose requires a definitive line rather than an overly conservative, natural correction

• Agreed to use a silicone implant after thorough consultation

Structural improvement

• Complete removal of foreign material from previous procedures

• Cartilage graft (septal cartilage / donor rib cartilage)

• Use of a silicone implant

• Combined functional nasal surgery for deviated septum and rhinitis to relieve nasal obstruction

Improvement in shape

• Achieved a harmonious nasal line through bulbous nose correction

• Improvement of drooping tip

• Enhanced nostril symmetry

• Achieved natural nasal height

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

Front view

• Bulbous nose corrected

• Improved nostril balance

• Symmetric nasal shape

• Overall harmonious appearance

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

Profile view

• Naturally elevated nasal line

• Improved tip position

• Adequate nasal height

• Improvement of the previous bulbous appearance

• Harmonious overall proportions

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

Nostrils

• Natural nostril shape

• Improved nostril symmetry

• Stable nasal framework

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

This case involved correcting a bulbous nose in a patient with a history of nasal filler in 2020 and nasal threads in 2023. The patient initially preferred an implant-free surgery; however, during the consultation, I explained that due to the anatomical characteristics of a bulbous nose, an overly subtle correction might not produce an adequate slimming effect.

A bulbous nose typically features a flatter appearance and insufficient nasal height, so establishing appropriate height and definition is necessary for effective correction. After a thorough consultation, the patient decided on using a silicone implant, which yielded a more effective result in resolving the bulbous contour.

The surgery began with the complete removal of foreign material from the previous procedures. Along with structural reconstruction using cartilage (septal cartilage and donor rib cartilage), a silicone implant was placed to effectively improve the flatness of the bulbous nose. Additionally, surgery related to nasal obstruction was performed concurrently to enhance breathing function.

Alongside bulbous nose correction, the drooping tip and nostril asymmetry were also addressed, creating an overall balanced and natural nasal contour. Because the patient was open to a subtle dorsal hump feel, we achieved a harmonious outcome with a gently curved nasal line rather than a strictly straight one.

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

Thank you.

#closedrhinoplasty #bulbousnosecorrection #foreignmaterialremoval #autologouscartilage #customrhinoplasty