Why nasal filler cannot correct a drooping tip and dorsal hump, and the reconstruction method after removal

Hello, I am Dr. Peter C. Kang.

Today, I would like to introduce the case of a patient who visited our clinic because her drooping tip and dorsal hump shape did not improve even after nasal filler and thread lifting.

The patient had a history of nasal trauma in childhood and later tried non-surgical methods to correct her nose.

• Childhood: Nasal injury from a frontal impact

• Approximately 2 years ago: Nasal filler procedure and PDO thread lifting

Because non-surgical procedures alone have limitations in resolving fundamental structural problems such as a drooping tip or dorsal hump shape, she decided on surgical correction.

The patient's specific requests were as follows:

• A prominent yet natural nasal line

• Improvement of the drooping nasal tip

• Dorsal hump correction

• Improvement in nasal obstruction (deviated septum and rhinitis symptoms)

In particular, she preferred a prominent nasal profile while maintaining a natural appearance, and she was open to the use of an implant.

1. Removal of nasal filler and foreign material

• Complete removal of existing nasal filler

• Clearing of residual threads

• Securing a clean surgical environment

2. Nasal tip plasty using autologous rib cartilage

• Reinforcement of the nasal tip support framework using autologous rib cartilage

• Naturally raising the drooping nasal tip

• Creating a well-defined yet natural tip line

3. Nasolabial angle correction

• Adjusting the nasolabial angle using autologous rib cartilage

• Forming a refined nasolabial angle when viewed from the profile

4. Nasal bridge augmentation using a silicone implant

• Silicone implant precisely carved to fit the nasal bone

• Implant placed solely along the nasal dorsum to maintain a natural shape

• Natural straight bridge line created from forehead to nasal tip

5. Septoplasty and inferior turbinate reduction

• Internal nasal structures realigned by correcting the deviated septum

• Rhinitis symptoms improved by reducing hypertrophied inferior turbinates

• Restoration of breathing function

Front view changes

• Elimination of the dorsal hump shape and completion of a smooth bridge line

• The nasal tip is naturally elevated, creating a refined impression

• Overall balanced nasal shape

Profile view changes

• The drooping nasal tip is elevated to an appropriate height

• Natural straight bridge line created from forehead to nasal tip

• A refined nasolabial angle achieved through angle correction

• The dorsal hump area is smoothly contoured

Changes on the oblique view

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

• A prominent yet refined tip line

• Nasal shape in harmony with the overall face

Changes in nostril shape

• As the tip is elevated, the nostril shape changes naturally

• Balanced, symmetric nostril shape

• An overall refined nasal base line

Non-surgical procedures such as nasal filler or thread lifting have the advantage of convenience, but they have limitations in fundamentally resolving structural problems such as a drooping tip or a dorsal hump. Like this patient, many decide on surgical correction when their concerns remain unresolved after non-surgical treatments.

In this surgery, the existing nasal filler was completely removed first, and then the support structure of the nasal tip was reinforced and naturally elevated using autologous rib cartilage. The nasolabial angle was also corrected with autologous rib cartilage to complete a refined profile silhouette. On the nasal bridge, a silicone implant was precisely carved to match the patient's nasal bone and placed strictly along the dorsum, creating a natural straight bridge line extending from the forehead to the nasal tip.

Additionally, the patient decided on the day of surgery to proceed with functional nasal surgery as well; septoplasty and inferior turbinate reduction were performed simultaneously to relieve nasal obstruction. Addressing functional concerns during rhinoplasty improves both aesthetics and function in a single surgery, reducing the patient's burden.

For rhinoplasty after nasal filler removal, it is important to accurately assess the condition of the existing filler and the reaction of the surrounding tissues. A surgical plan must be established by comprehensively evaluating which layer the filler is located in and how much it has affected the surrounding tissues to achieve stable and satisfactory results. Based on this detailed analysis, NOSELAB proposes the surgical method tailored to each patient's nasal condition.

I hope this has been helpful to those facing similar concerns. This has been Dr. Peter C. Kang, Medical Director. Thank you.

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