Why nasal obstruction worsens after rhinoplasty: How septal reconstruction and osteotomy reversal are performed

Hello, I am Dr. Peter C. Kang.

Today, I would like to share the case of a patient who visited our clinic after developing severe nasal obstruction and nostril asymmetry following a prior rhinoplasty.

• Prior rhinoplasty

• Nostril asymmetry resulting from alar reduction

• Worsened nasal obstruction symptoms

• Relief of worsening nasal obstruction after rhinoplasty

• Correction of nostril asymmetry caused by alar reduction

• Simultaneous resolution of functional and cosmetic concerns

1. Skin graft to correct nostril asymmetry

• Performed a skin graft on the left nostril wing (ala)

• Improved asymmetry caused by alar reduction

2. Restoration of previous osteotomy

• Restoration of the excessively narrowed nasal dorsum from over-osteotomy

• Restored a natural dorsal line through osteotomy reversal

3. Septal reconstruction

• Mobilized the septum, which had completely collapsed to the left, toward the right

• Refixed the septum to establish structural stability

• Sturdily reinforced the existing septum using autologous rib cartilage

4. Implant exchange

• Removal of existing silicone implant

• Customized and placed a new silicone implant to fit the nasal bone

5. Functional surgery

• Correction of deviated septum

• Performed rhinitis surgery simultaneously

• Addressing the root cause of nasal obstruction

Cosmetic improvements:

• Correction of nostril asymmetry

• Naturally restored the narrowed nasal dorsum

• Improvement in the overall nasal line

Functional improvement:

• Relief of nasal obstruction symptoms

• Restored breathing function through correction of the deviated septum

• Improvement in chronic nasal obstruction through rhinitis surgery

Structural stability:

• Secured long-term structural stability by reinforcing the septum with autologous rib cartilage

• Maintained a sturdy nasal framework after revision surgery

Nasal obstruction and asymmetry developing after rhinoplasty cannot be resolved through superficial aesthetic corrections alone. In cases like this, where severe septal damage and complex structural issues coexist, a systematic approach that addresses both function and appearance simultaneously is essential.

Septal reconstruction, in particular, demands high-level surgical expertise. Mobilizing a collapsed septum back into position and reinforcing it with autologous rib cartilage must be supported by an accurate understanding of anatomy and extensive surgical experience.

In addition, restoring over-osteotomized nasal bones and correcting nostril asymmetry with skin grafting require meticulous planning and delicate technique. Through this procedure, the patient was able to address both the long-standing nasal obstruction and asymmetry in a single surgery. I hope this case provides helpful insight for those experiencing similar concerns.

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

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