Why the nose flattens and widens after double-jaw surgery, and septal reconstruction

Hello, I am Dr. Peter C. Kang.

Today, I would like to introduce the case of a patient who visited our clinic concerned about their nose becoming wider and lower after double-jaw surgery.

December 2021: Revision rhinoplasty using autologous rib cartilage + autologous dermis + 3D printing + functional nasal surgery

February 2022: Release of internal nasal synechia (adhesions)

August 2022: Revision tip rhinoplasty + autologous dermis

February 2023: Revision rhinoplasty

October 2023: Revision rhinoplasty (overall reduction in height)

June 2025: Double jaw surgery (two-jaw surgery)

After double-jaw surgery, changes to the nasal support structure caused the nose to spread and become lower overall.

The patient was troubled by the changes in nasal shape following double-jaw surgery.

Main requests:

• Improvement of a wide nose

• Elevating the lowered nasal tip

• Natural bridge line

• A soft, non-pointed appearance for the nasal tip

1. Assessment of the septum

The septal cartilage had been significantly weakened by the double-jaw surgery. Because a weakened septum could not adequately raise and support the nasal tip, reconstruction using autologous tissue was necessary.

2. Septal reconstruction using autologous rib cartilage

We harvested autologous rib cartilage to reinforce and reconstruct the weakened septum.

Advantages of autologous rib cartilage:

• No tissue rejection because it is autologous tissue

• Maintaining tip height with strong support

• Long-term stable outcome

• Effectively reinforcing the structure weakened after double-jaw surgery

We naturally elevated the nasal tip over the reconstructed septum.

3. Connecting the bridge with a silicone implant

To create a seamless transition with the elevated nasal tip, we custom-carved and placed a silicone implant along the nasal bridge. This formed a smooth, continuous line from the nasal tip to the bridge.

4. Refining the nasal tip shape

In accordance with the patient's request, the nasal tip was refined to have a soft, natural contour rather than a pointed look.

Front view changes:

• A previously splayed nose now appears centered and defined

• An overall neat, well-balanced nasal shape

• Harmonious balance with the entire face

Profile view changes:

• Naturally elevated from a previously low nasal tip

• Smooth transition between the nasal bridge and tip

• Achieving a natural nasal line

Nasal tip changes:

• A soft, non-pointed nasal tip

• Securing stable support

• Natural height and shape

In cases like this, it is difficult to achieve adequate support using an implant alone. As demonstrated here, reconstructing the weakened septum with autologous rib cartilage and re-establishing the structural foundation of the nasal tip is essential.

To achieve the soft and natural nasal tip requested by the patient, the surgery was performed without excessive elevation, maintaining harmony with the entire face. I hope this provides helpful insight for those concerned about nasal shape changes after double-jaw surgery. This has been Dr. Peter C. Kang, Medical Director. Thank you.

#closedrhinoplasty #closedrevisionrhinoplasty #autologousribcartilage #septalreconstruction #revisionrhinoplasty #rhinoplastyafterorthognathicsurgery #naturalnose