Why the nostrils look severely uneven on both sides: cartilage reconstruction and skin graft correction

Hello, I am Dr. Peter C. Kang.

Today, I would like to introduce a revision rhinoplasty case of a patient who visited our clinic with concerns about severe nostril asymmetry.

Following a previous rhinoplasty, nostril asymmetry and a crooked nose remained, requiring corrective surgery.

• Correction of severe nostril asymmetry

• Correction of deviated nose

• Resolution of nasal obstruction symptoms

• A natural and well-balanced nasal line

1. Correcting lower lateral cartilage asymmetry

• Precise trimming of lower lateral cartilages that had marked congenital asymmetry

• Refining the nasal tip shape using tip suturing

• Reconstructing deficient cartilage to secure bilateral symmetry

2. Septal reconstruction to correct the crooked nose

• Repositioning the nasal tip to the midline through septal reconstruction

• Maintaining long-term results by securing structural stability

3. Nostril size adjustment: free composite graft

• Performing a free composite graft to slightly enlarge the right nostril

• Achieving a natural nostril contour via a skin graft inside the nostril

4. Implant exchange

• Removal of existing silicone implant

• Precisely carving a new silicone implant to fit the patient's nasal bone

• Formation of a natural bridge line

5. Concurrent functional surgery

• Performing deviated septum surgery to improve nasal obstruction

• Improving breathing function through rhinitis surgery

Front view changes:

• Severe nostril asymmetry was balanced and corrected

• The crooked nose was realigned along the midline

• An overall harmonious nasal shape was achieved

Profile view changes:

• Natural bridge line

• Stable positioning of the nasal tip

• A smooth silhouette with the new implant

Functional improvement:

• Relief of nasal obstruction through septoplasty

• Improved breathing function through rhinitis surgery

Nostril view changes:

• Balanced nostril size on both sides

• Natural inner nostril lining achieved with a free composite graft

• Symmetric nostril shape

Correcting nostril asymmetry is one of the areas in rhinoplasty that requires the most delicate technique. In cases like this where severe congenital asymmetry of the lower lateral cartilages exists, simple cartilage suturing alone has clear limitations.

In this surgery, cartilage trimming, cartilage reconstruction, and a free composite graft were combined to balance both nostrils. A free composite graft is an advanced technique used when there is insufficient skin inside the nostril, regulating nostril size and contour through skin grafting.

In addition, septal reconstruction was performed to correct the crooked nose, and septoplasty and rhinitis surgery were carried out together to address nasal obstruction, achieving both aesthetic and functional improvements at the same time.

In revision rhinoplasty, it is essential to accurately assess the condition of existing tissues and the impact of previous procedures. Through a tailored approach suited to the patient's condition, we were able to achieve satisfying results. I hope this case helps those who share similar concerns. This has been Medical Director Dr. Peter C. Kang. Thank you.

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