How tip structure and nostril show are addressed in primary rhinoplasty

Hello, I am Dr. Peter C. Kang.

Today, I would like to introduce the case of a patient who visited our clinic seeking a natural yet refined change through primary rhinoplasty.

This patient was having rhinoplasty for the first time and chose our clinic after careful consideration.

Health status and considerations:

- Suspected rhinitis symptoms

- Strong focus on safety as a primary surgery

Areas requested for improvement:

- Desired a natural-looking nose

- Open to using a silicone implant

- Desired nasal tip refinement

- Reduced nostril visibility

The patient wanted natural improvement rather than dramatic changes, and considered reducing front-view nostril show to be particularly important.

1. Raising the nasal bridge with a silicone implant

- An appropriate height suited to the face

- A bridge line with a gentle curve

- Natural elevation

- Smooth transition from forehead to nasal tip

2. Nasal tip refinement with septal cartilage and donor rib cartilage

- Establishing the base structure with septal cartilage

- Securing sufficient height and structural support with donor rib cartilage

- A defined yet natural tip

- A stable framework for long-term maintenance

3. Nasolabial angle correction

- Minimizing nostril show

- An ideal angle on the profile view

- Achieving an elegant profile

4. Functional rhinoplasty

- Septoplasty

- Submucosal resection of the inferior turbinate

- Expected improvement in rhinitis symptoms

- Ensuring comfortable breathing

1. Natural-looking change

- Natural refinement without an artificial appearance

- Harmonious integration with the facial features

- Feedback from others confirming a natural look

2. An ideal nasal tip

- Well-balanced tip projection

- A defined yet soft contour

- A satisfying appearance from both the front and profile views

3. Improvement in nostril show

- Minimal nostril visibility on the front view

- Maintaining a natural angle

- An overall refined impression

4. Functional improvement

- Easier breathing through the nose

- Relief of rhinitis symptoms

- Improved quality of daily life

In primary rhinoplasty, the native nasal structures remain preserved, which generally makes the surgical process smoother. However, because patients' expectations are correspondingly high, the procedure must be approached with great care.

When a natural result is desired, as in this case, facial harmony is prioritized over dramatic changes. An appropriate bridge height was created with a silicone implant, and septal cartilage combined with donor rib cartilage formed a stable yet natural nasal tip.

Reducing nostril visibility is a common goal for many patients. By properly adjusting the nasolabial angle, nostril show on the front view was minimized while maintaining a pleasing line on the profile view. Lowering the angle excessively can make the nose appear drooping, so finding the right balance is essential.

Compared to autologous rib cartilage, donor rib cartilage does not require a donor-site harvest, offering the advantages of reduced operative time and faster recovery. Advances in processing technology have also made its use very reliable. When combined with septal cartilage, it provides sufficient structural support while producing a natural result.

Performing functional nasal surgery concurrently allows for expected improvement in rhinitis symptoms. Achieving comfortable breathing alongside aesthetic enhancement offers a dual benefit.

I will continue to carefully evaluate each patient's individual characteristics and goals to deliver the most satisfying outcomes possible.

This was Dr. Peter C. Kang. Thank you.

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