Why an arrow nose appears only when smiling and how to correct tip cartilage

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

Today, I would like to share a natural nasal tip rhinoplasty case for a patient concerned about a dorsal hump and an arrow nose that appeared when smiling.

Functional issues

• Rhinitis symptoms

• Recent worsening of nasal obstruction (right > left)

Aesthetic concerns

• Dorsal hump shape

• Crooked nose

• Drooping tip

• Arrow nose phenomenon when smiling

• Bulbous nasal tip appearance

• Nose appearing long

• Dorsal hump reduction

• Correction of the crooked nose

• Improvement of drooping tip

• Improvement of the arrow nose when smiling

• Creating a slim nasal tip

• Correction of the blunt appearance

• Improving the elongated appearance

Structural improvement

• Nasal tip rhinoplasty using autologous rib cartilage due to small septal cartilage

• Dorsal hump reduction

• Correction of the crooked nasal bridge using osteotomy

• Improvement of a drooping tip

Specialized nasal tip correction

• Refining a bulbous nasal tip into a slim shape

• Correction of the arrow nose phenomenon when smiling

• Improvement in elongated appearance

• Achieving a natural tip shape

Functional improvement

• Correction of rhinitis and deviated septum through septoplasty and radiofrequency laser submucosal inferior turbinectomy

Functional improvement

• Alleviation of rhinitis symptoms

• Relief 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

• Naturally corrected arrow nose

• Improvement of the crooked nose

• Slim and 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

• Smoothly contoured dorsal hump line

• Correction of the drooping tip

• Adequate nasal length

• Harmonious profile contour

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

Changes with facial expressions

• Expected improvement of the arrow nose phenomenon when smiling

• Refined nasal tip with bulbousness eliminated

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

This case involved a patient who was concerned about a dorsal hump, a crooked nose, and especially an arrow nose phenomenon that appeared when smiling. An arrow nose that becomes apparent when smiling is a complex problem resulting from the structure of the nasal tip cartilage and the pull of facial muscles, making it difficult to resolve with simple nasal tip surgery alone.

The patient's primary concerns were the arrow nose phenomenon in which the nasal tip drooped long when smiling, and the bulbous appearance of the nasal tip at rest. In addition, the patient wished to improve the overall elongated look of the nose.

While dorsal hump correction and crooked nose correction are relatively common procedures, meticulous adjustment of the nasal tip was the key in this case. Using autologous rib cartilage, it was important to make the nasal tip slim while minimizing unnatural distortion during smiling.

To address the arrow nose that appears when smiling, the shape and position of the nasal tip cartilage must be precisely adjusted. The cartilage was repositioned to refine the bulbous tip while preventing excessive deformation with facial expressions.

In addition, to improve the elongated appearance of the nose, overall proportions were adjusted, and the drooping tip was suitably elevated to achieve a balanced nasal contour. The dorsal hump was also naturally smoothed to create a soft profile line.

Functionally, to relieve the recently worsened nasal obstruction and rhinitis symptoms, septoplasty and radiofrequency laser submucosal inferior turbinectomy were performed concurrently.

As a result, the arrow nose phenomenon when smiling—which was the patient's greatest concern—was substantially improved, and a slim, refined nasal tip without bulbousness was achieved at rest. The dorsal hump and crooked nose were also naturally corrected, making this a rewarding case that achieved a harmonious overall nasal shape.

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

Thank you.

#closedrhinoplasty #dorsalhumpcorrection #arrownosecorrection #slimnasaltip #autologouscartilage #customrhinoplasty