Why the glabella widens and the nasal tip upturns after repeated filler and thread treatments

Hello, I am Dr. Peter C. Kang.

Today, I would like to introduce the case of a patient who visited our clinic after remaining dissatisfied with her nasal shape despite repeated procedures and revision surgery.

The patient was a complex case with a history of multiple procedures and surgeries.

- 4 years ago: Two-jaw surgery to improve facial contour

- 7 to 8 years ago: Cartilage tie (suture) procedure

- Since then: Repeated periodic filler and thread treatments every year

- 6 months ago: Silicone implant placement and abdominal dermis graft

Despite these multiple procedures, the patient was unsatisfied with her tip shape and overall balance. In particular, repeated filler treatments caused the glabella area to widen, and the nasal tip had become upturned, resulting in excessive nostril show.

The patient's specific requests were as follows:

- Creating a refined nose line similar to Karina's style

- Sufficiently elevating the nasal tip and columella to achieve a three-dimensional contour

- Correcting the upturned nose and reducing nostril show

- Wanting an effect that makes the midface look shorter

- Achieving a natural yet feminine silhouette

1. Complete removal of foreign material

- Removal of existing silicone implant and dermis

- Debridement of tissue affected by repeated filler injections

- Correction of the spreading in the glabella area

2. Partial septal reconstruction using autologous rib cartilage

- Establishing a stable support structure

- Adjustment of nasal tip height and angle

- Securing long-term stability

3. Nasal tip correction and columella elevation

- Forming a well-defined tip in Karina's style

- Sufficiently elevating the columella to establish a refined line

- Minimizing nostril show

4. Correction of nasolabial angle

- Improvement of upturned nose

- Making the midface appear shorter

- Improvement of profile silhouette

5. Refinement of the glabellar line

- Correcting the glabella that had widened from foreign material

- Forming a natural radix starting point

- Restoring overall balance

Front view changes

- The glabella, which had widened due to foreign material, has been naturally smoothed and refined

- The upturned nasal tip has been lowered to an appropriate angle

- The blunt tip has transitioned into a well-defined, refined contour

- Nostril show has been significantly reduced

Profile view changes

- The upturned nose has been corrected to establish a natural angle

- The radix starting point has been adjusted to an appropriate height

- The nasolabial angle was corrected favorably, creating an effect that visually shortens the midface

- An overall three-dimensional and feminine line has been achieved

Overall change in impression

- A refined and striking nose line in Karina's style has been created

- Harmonic balance with the entire face

- A natural yet distinct silhouette

- A more feminine and elegant image

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

This was a high-difficulty revision rhinoplasty case where the tissue condition was complex due to multiple procedures and surgeries. Because we had to consider tissue deformity caused by repeated filler injections and foreign materials, along with a history of two-jaw surgery, a very meticulous approach was required.

Partial septal reconstruction using autologous rib cartilage was a suitable choice to obtain a stable result even in such complex circumstances. Using the patient's own tissue allowed us to create a natural shape without rejection reactions, supporting long-term structural stability.

In particular, the Karina-style nose the patient desired does not simply mean raising the height; the angle of the tip, the position of the columella, and the overall balance must all work in harmony. Through this surgery, we were able to correct the upturned nose while creating a refined line, faithfully reflecting the patient's goals.

Revision rhinoplasty requires more experience and skill than a primary procedure. This is because scar tissue, altered anatomy from previous surgeries, and the patient's psychological burden must all be addressed. NOSELAB prioritizes patient satisfaction even in these complex revision cases and strives to achieve the intended result.

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

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