Why we look at the facial axis first when correcting a nose with facial asymmetry

Hello, I am Dr. Peter C. Kang.

Today, I would like to share the case of a patient who visited our clinic concerned about noticeable facial asymmetry and a crooked nose. The goal was not simply to straighten the nose alone, but to create a nose that harmonizes naturally by taking the axis of the entire face into account.

• 10 years ago: Nasal filler procedure (touch-up 2 years later)

• 4 years ago: Orbital fracture

• 2013: Facial contouring surgery

• Correction of crooked nose

• A natural-looking nose that takes facial asymmetry into account

• Improvement of a drooping tip

• Correction of the blunt appearance

1. Crooked nose correction taking the facial axis into account

• A design reflecting facial asymmetry as much as possible

• Adjusting the nasal position to align with the central facial axis

• Achieving a natural sense of symmetry

2. Focusing on asymmetry correction

• Correction of the crooked nasal bridge line

• Improvement of asymmetry in the nasal bones and cartilages

• Creating a well-balanced nose on the front view

3. Nasal tip elevation and reshaping

• Naturally raising the drooping tip

• Improvement in bulbous appearance

• Creating a masculine yet refined nasal tip

4. Correction of nasolabial angle

• Correction of the drooping appearance

• Improvement of the profile silhouette

5. Removal of existing filler

• Clearing the areas previously treated with filler

• Building a new structure on a clean foundation

1. Frontal changes

• A crooked nose aligned to fit the facial axis

• A nose that fits naturally despite underlying facial asymmetry

• An overall balanced appearance

2. Profile changes

• Appropriate elevation of the previously drooping tip

• A refined profile line with reduced bluntness

• A masculine yet natural nasal height

3. Nostril changes

• Balanced nostril shape through tip correction

• An overall neat and organized appearance

Rhinoplasty for individuals with facial asymmetry requires a different approach from standard rhinoplasty. The goal cannot simply be to make the nose straight in isolation; one must create a nose that blends naturally while accounting for the axis and balance of the entire face.

In this case, because of past histories of an orbital fracture and facial contouring surgery, the facial structure differed from typical anatomy. Simply placing the nose strictly in the geometric center under these conditions can actually look unnatural. By thoroughly analyzing the patient's facial axis, we established the position and orientation of the nose accordingly.

In addition, the blunt, drooping tip was appropriately elevated to create a refined impression. For male patients, an overly high or sharp tip does not look fitting, so we aimed for a line that is both masculine and natural.

Some patients hesitate to undergo rhinoplasty because of facial asymmetry, but cases like this are precisely where specialized analysis and a customized surgical plan are essential. Through surgery planned with overall facial harmony in mind, a satisfying result can be achieved.

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

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