Why septal cartilage damage causes a drooping tip and a retracted columella

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

Today, I would like to introduce a case where a retracted columella and drooping tip caused by severe septal cartilage damage were corrected.

• 2 years ago: autologous rib cartilage + silicone implant

Functional issues

• Rhinitis symptoms

• Septum deviated to the left

• Sinusitis

Aesthetic concerns

• Significantly drooping tip

• Retracted columella

• Nose appearing crooked

• Irregularities on the nasal bridge

• High radix

Intraoperative findings

• Severe damage to the septal cartilage confirmed

• Structural deformity determined to be caused by cartilage damage

• Improvement of a drooping tip

• Restoration of the retracted columella ("I want my columella to project nicely")

• Lowering the radix

• Improvement of a crooked-appearing nose

• Smoothing of nasal bridge irregularities

Septal reconstruction

• Severe damage to the septal cartilage confirmed during surgery

• Septal reconstruction using autologous rib cartilage

• Correction of the left-deviated septum

Structural improvement

• Septal extension using autologous rib cartilage

• Restoration of the retracted columella

• Elevation of the drooping tip

• Correction of the nasolabial angle

Morphological improvement

• Refining a splayed nasal tip naturally

• Lowering the radix

• Smoothing of bridge irregularities

• Correction of crooked nose appearance

Functional improvement

• Deviated septum and rhinitis surgeries performed concurrently to improve rhinitis and sinusitis

Functional improvement

• Alleviation of rhinitis symptoms

• Preventing worsening of sinusitis

• Smooth breathing function

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 crooked nose appearance

• Naturally refined nasal tip

• Balanced overall proportions

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

Profile view

• Elevated, well-defined nasal tip

• Naturally lowered columella

• Refined profile line achieved by lowering the radix

• Improved nasolabial angle

• Improvement in protruding mouth appearance

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

Overall changes

• Improvement in the elongated appearance

• Splayed nasal tip naturally brought together

• Smoothed bridge surface

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

This patient had rhinitis and sinusitis, with a drooping tip and a retracted columella as the main concerns. Intraoperative assessment confirmed that severe damage to the septal cartilage was the primary cause of these deformities.

Damage to the septal cartilage not only creates functional problems, but it also weakens the structural support of the nose, leading to tip drooping and columellar retraction. In this case as well, the overall supporting framework of the nose had collapsed due to the damaged septum.

To resolve this at its root, septal reconstruction was performed using autologous rib cartilage. By fully reconstructing the damaged septum, structural stability was re-established, and a septal extension was performed simultaneously to elevate the drooping tip.

The retracted columella was naturally restored upon the newly reconstructed septal foundation, achieving the patient's goal of a beautifully shaped columella. Correcting the nasolabial angle also improved the profile line and softened the appearance of a protruding mouth.

In addition, lowering the radix appropriately and smoothing the bridge irregularities established a refined profile line. The wide, splayed tip was naturally brought together, and the overly elongated look was corrected to create a balanced nasal shape.

From a functional perspective, functional nasal surgery was conducted alongside septal reconstruction to address the rhinitis and sinusitis, thereby improving breathing.

By resolving the underlying cause of septal cartilage damage, this comprehensive reconstruction simultaneously corrected the drooping tip and retracted columella while also addressing functional concerns.

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

Thank you.

#closedrhinoplasty #septalreconstruction #retractedcolumella #droopingtipcorrection #autologousribcartilage #customrhinoplasty