Why nostrils narrow and breathing becomes difficult after philtrum reduction, and how to correct it

Hello, I am Dr. Peter C. Kang.

Today, I would like to share the case of a patient who was troubled by an asymmetric nose and impaired breathing following a previous philtrum reduction, whom we helped achieve a natural, balanced nose.

Past history:

• 13 years ago: silicone implant + ear cartilage

• 12 years ago: silicone implant repositioning (deviated to the left)

• Recently: philtrum reduction + closed rhinoplasty (additional ear cartilage)

Main concerns:

• Asymmetric nose deviated to the left

• Unnatural appearance following previous reduction

• Severe protruding mouth

• Reduced airflow and asymmetry due to a narrowed left nostril

Special notes:

• Significantly impaired breathing after surgery

• Breathing improvement (top priority)

• Correction of asymmetric nose

• Slight elevation of overall nasal height

• Improvement in a protruding mouth

• Correction of nostril asymmetry

1. Correction of asymmetric nose via lateral osteotomy

The nasal bones tilted to the left were precisely corrected with lateral osteotomy. Repositioning the nasal bones established a symmetric and natural line on the front view.

2. Relieving the protruding mouth via nasolabial angle correction

The unnatural shape and aggravated protruding mouth resulting from the prior reduction were resolved by correcting the nasolabial angle. By carefully adjusting the angle between the nose and upper lip, the profile line became more balanced and well-defined.

3. Restoring breathing with left nostril skin graft

The left nostril, which had narrowed after the previous reduction, was partially widened with a skin graft. Breathing was promptly restored, and the asymmetry was naturally improved.

4. Overall height enhancement

The overall nasal height was elevated appropriately to match the patient's facial proportions, creating a natural and refreshed appearance.

• Realignment of asymmetric nasal bones via lateral osteotomy, symmetric front view

• Relief of protruding mouth through nasolabial angle adjustment, refined profile line

• Widening of narrowed nostril via skin graft, restored breathing

• Refreshed impression with appropriate height enhancement

• Overall natural and balanced nose achieved

This was a complex case requiring simultaneous correction of impaired breathing, nasal asymmetry, and a protruding mouth resulting from prior procedures.

Refining an asymmetric nose:

An asymmetric nose compromises front view balance. Precisely repositioning the nasal bones through lateral osteotomy creates a natural, balanced contour. Fine control over bone movement is key.

Resolving aftereffects of reduction surgery:

Philtrum reduction requires careful planning. If overdone, nostrils can narrow and a protruding mouth can appear more pronounced. Carefully adjusting the nasolabial angle enhances the profile contour three-dimensionally.

Nostril widening and breathing restoration:

A narrowed nostril directly compromises breathing. Securing the airway with a skin graft provides prompt functional relief. It also naturally resolves asymmetry, enhancing the front appearance.

Overall harmony:

When elevating nasal height, both breathing and aesthetics must be considered. Appropriately tailoring the height to the patient's facial proportions creates a natural and refreshed impression.

At NOSELAB, we will continue to accurately identify the underlying issues of prior surgeries and do our utmost as a specialized revision clinic to improve both breathing and aesthetics.

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

#closedrhinoplasty #closedrevisionrhinoplasty #crookednosecorrection #lateralosteotomy #nasolabialanglecorrection #protrudingmouthcorrection #nostrilwidening #nasalfunctionimprovement #revisionspecialist