Why nasal obstruction persists despite multiple surgeries: Correcting nasal valve stenosis and nostril asymmetry

Hello, I am Dr. Peter C. Kang.

Today, I would like to share the case of a patient who visited our clinic after suffering from severe nasal obstruction and nostril asymmetry despite undergoing multiple previous surgeries.

The patient was a complex case with a history of multiple procedures and surgeries.

• 16 years ago: Nasal filler injection

• 10 years ago: Nasal bridge surgery using a silicone implant

• 7 years ago: Nasal tip surgery adding ear cartilage to the existing silicone implant

• 6 months ago: Autologous rib cartilage, silicone implant, alar reduction, and functional nasal surgery

Despite undergoing multiple surgeries, the primary issue—nasal obstruction—had not improved. In fact, after the most recent surgery, the right nostril had narrowed, making breathing even more difficult.

The patient's specific requests were as follows:

• Functional improvement as the primary goal (especially relieving right-sided nasal obstruction)

• Improvement of nostril asymmetry

• Naturally lowering the bridge height

• Refining the nasal tip to make it slimmer

• Reducing the overall width of the nose

1. Removal of existing foreign material and structural reconstruction

• Removal of existing implants and graft materials

• Debridement of tissue deformed by previous surgeries

• Reconstruction of a stable support structure using rib cartilage

2. Septoplasty

• Correction of the right-deviated septum

• Securing an open breathing airway

• Restoring internal structural stability of the nose

3. Correction of nasal valve stenosis

• Improving the narrowed right nasal valve area

• Restoration of breathing function

4. Turbinoplasty

• Correction of hypertrophic inferior turbinates

• Improving intranasal airflow

5. Adjusting dorsal height and nasal base reduction

• Naturally adjusting overall nasal height

• Improving balance through nasal base reduction

6. Correction of nostril asymmetry

• Widening the narrowed right nostril by adjusting columellar width

• Balancing nostril size using a skin graft

• Restoring symmetry between both nostrils

Front view changes

• The overall nasal width has been naturally reduced.

• The nasal tip has been refined into a slimmer contour.

• Nostril asymmetry has improved, resulting in a well-balanced appearance.

Profile view changes

• The nasal height has been naturally adjusted.

• The dorsal line is smooth and natural.

• Overall proportions are harmonious with the face.

Changes on the oblique view

• Natural nasal contour visible even at a 45-degree angle

• Refined adjustments to the nasal tip stand out.

• Enhancing overall facial balance

Changes in nostril shape

• The narrowed right nostril has been enlarged to an appropriate size.

• Symmetry between both nostrils has significantly improved.

• Adjusting the columellar width resulted in a natural nostril shape.

This is a revision case involving functional problems where nasal obstruction was not resolved despite multiple surgeries, but rather worsened. Because previous surgery had led to right nostril narrowing, septal deviation, and nasal valve stenosis, a meticulous approach was essential.

In rhinoplasty, functional aspects are just as crucial as aesthetic ones. No matter how attractive a nose looks on the outside, impaired breathing significantly interferes with a patient's daily life. In this procedure, we focused on restoring respiratory function by straightening internal nasal structures through septoplasty and turbinoplasty, as well as correcting the narrowed nasal valve area.

In addition, the narrowed right nostril was addressed by precisely adjusting the columellar width combined with a skin graft to balance both nostrils. By adjusting the dorsal height and reducing the nasal base, overall balance was improved, achieving both functional and aesthetic goals.

Because revision rhinoplasty requires addressing scar tissue and deformed structures from previous surgeries, it demands higher levels of experience and surgical skill than a primary procedure. When functional problems are also present, a comprehensive surgical plan accounting for both internal structure and external appearance is essential. NOSELAB strives to deliver the intended results even in such complex revision cases by meticulously resolving the patient's functional discomfort.

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

#closedrhinoplasty #closedrevisionrhinoplasty #nasalobstructionsurgery #septoplasty #nasalvalvestenosis #revisionrhinoplasty #functionalrhinoplasty #nostrilasymmetry #dorsalreduction