Causes of nasal tip show-through and correction methods to lower the tip defining point

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

Today, I would like to introduce a case of natural improvement for a patient who was troubled by nasal tip show-through, an upturned nose, and excessive nostril show.

• 10 years ago: Nasal filler injection → removed during surgery

• 2015 (10 years ago): Silicone implant + ear cartilage surgery

• 2018 (7 years ago): Ear dermis graft surgery due to nasal tip show-through

Functional issues

• Rhinitis (alternating runny nose and nasal obstruction, sneezing)

Aesthetic concerns

• The left side of the nose appears depressed

• Nasal tip show-through (persists even after the ear dermis graft)

• Upturned nose

• Nostril show

• Deviated nose

• Improvement of the depressed left side and show-through

• Wants to lower the tip defining point even if the nose becomes lower

• Correction of an upturned nose

• Reduction of nostril show

• Correction of deviated nose

Resolution of nasal tip show-through

• Complete removal of 10-year-old nasal filler residue

• Naturally lowered tip defining point

• Improvement of the depression on the left side of the nose

Structural improvement

• Tip plasty using autologous rib cartilage

• Correction of upturned nose

• Correction of deviated nose

• Reduction of nostril show

Functional improvement

• Improvement of rhinitis through septoplasty and radiofrequency submucosal turbinoplasty of the inferior turbinates

Functional improvement

• Relief of rhinitis symptoms (improvement of runny nose, nasal obstruction, and sneezing)

• 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

• Improvement of the depression on the left side of the nose

• Resolution of nasal tip show-through

• Correction of crooked nose

• 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

• Naturally lowered tip defining point

• Correction of an upturned nose

• Balanced profile line

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

Nasal tip

• Resolved show-through issue

• Natural nasal tip shape

• Smooth nasal tip contour

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

This patient had been troubled by nasal tip show-through for a long time. After the initial surgery in 2015 using a silicone implant and ear cartilage, nasal tip show-through developed; an ear dermis graft was performed in 2018, but the visibility issue still remained.

The patient's greatest concern was that the left side of the nose looked depressed while simultaneously showing cartilage visibility. In addition, excessive nostril show due to an upturned nose was a significant concern. Most notably, the patient clearly stated, "Even if the nose becomes lower, I want to lower the tip defining point."

Nasal tip show-through occurs when the skin is thin or the cartilage is overly prominent, making it one of the more challenging issues to correct once it occurs. The fact that show-through remained even after a previous ear dermis graft meant that a fundamental approach was necessary.

First, the residue from the 10-year-old nasal filler was completely removed to create a clean environment. Then, according to the patient's request, surgery proceeded in the direction of naturally lowering the tip defining point. We carefully respected the patient's clear preference for a natural, show-through-free nose rather than a high nose.

Meticulous adjustments were made to improve the depression and visibility on the left side of the nose, and the upturned nose was naturally resolved alongside the repositioning of the nasal tip. Nostril show was also noticeably reduced, significantly improving the frontal appearance.

The crooked nose was corrected at the same time to create an overall balanced nasal shape. Most importantly, the show-through issue that the patient wanted resolved most was fundamentally addressed, resulting in a natural and smooth nasal tip.

From a functional standpoint, septoplasty and radiofrequency laser submucosal resection of the inferior turbinates were performed concurrently to improve rhinitis symptoms such as runny nose, nasal obstruction, and sneezing.

As a result, we resolved the nasal tip show-through that troubled the patient most, while comprehensively improving the upturned nose, nostril show, and crooked nose. It was a meaningful case where we fully respected the patient's request—even if it meant lowering the height—to achieve a natural and satisfying result.

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

Thank you.

#closedrhinoplasty #tipshowthroughcorrection #upturnednosecorrection #nostrilshowcorrection #naturalnasaltip #customrhinoplasty