Why short, upturned noses and crooked noses occur together, and how to correct them with septal extension

Hello, I am Dr. Peter C. Kang.

Today, I would like to share the case of a patient who visited our clinic with concerns regarding a short, upturned, and crooked nose.

Past surgical history:

• 15 years ago: L-shaped silicone implant + ear cartilage

• 10 years ago: Filler

• Correction of short and upturned nose

• Crooked nose correction

• Correcting a nose that was small and low relative to the face to match facial proportions

• A natural yet refined line

In this surgery, rather than simply making the nose higher and longer, our top priority was harmony with the overall face.

1. Septal extension

• Tip extension using autologous rib cartilage

• Naturally lowering the short, upturned nasal tip

• Reinforcement of nasal tip support

2. Crooked nose correction

• Correction of the deviated nasal bridge

• Aligning the nasal midline through septal correction

• Securing symmetry

3. Nostril correction

• Improvement in nostril shape

• Correcting nostril asymmetry

4. Correction of nasolabial angle

• Improvement of the profile silhouette

• Natural angle with the philtrum

5. Functional improvement (including nasal valve reconstruction)

• Securing internal nasal space

• Correction of the septum

• Inferior turbinate surgery

• Improving respiratory function through nasal valve reconstruction

Front view changes:

• Securing symmetry through crooked nose correction

• Natural height suited to facial proportions

• Creating a refined bridge line

Profile view changes:

• The short, upturned tip was naturally lowered

• Forming an elegant straight bridge line

• Refined profile line through an improved nasolabial angle

• A harmonious angle with the philtrum

Nostril view changes:

• The previously upturned nostrils were naturally improved

• Securing nostril symmetry

• Alignment of the columellar midline

Correcting a short, upturned nose is a very delicate procedure that requires considering overall facial proportions rather than simply elongating the nose. In this particular case, because the nose was small and low relative to the face, restoring balanced proportions was the key objective.

However, skin has a limit to how much it can stretch. If the nose is made excessively high or long, the skin cannot withstand the tension, which can lead to subsequent complications such as deformation or contracture. Therefore, harmonizing height with proportion is the most critical element.

In this type of case, we secured stable support through septal extension using autologous rib cartilage while establishing an appropriate height and length that accounted for the limits of the skin. Additionally, symmetry was achieved through crooked nose correction, and the nasolabial angle was adjusted appropriately to create a natural, refined line.

The structural support of the nasal tip is particularly critical when correcting a short, upturned nose. If one merely stretches the skin without adequate structural support, the tip can shorten or become upturned again over time. Therefore, we used a structural approach with autologous rib cartilage to support a stable result over the long term.

We also improved functional aspects at the same time. Through septal correction, inferior turbinate surgery, and nasal valve reconstruction, breathing function was enhanced as well. I believe a truly successful procedure achieves both aesthetic and functional improvement simultaneously.

I will continue to provide customized surgeries that reflect each patient's individuality and requests through this meticulous approach. I hope this helps those with similar concerns.

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

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