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Nasal obstruction and functional nasal surgery: records of external shape and internal airway

Cases involving nasal obstruction represent records where cosmetic rhinoplasty concerns intersect with breathing difficulties. These include a primary surgery patient who had a dorsal hump, crooked nose, and nasal obstruction caused by a deviated septum, as well as a revision patient whose intranasal mucosa developed adhesions after surgery, resulting in severe unilateral nasal obstruction. Even with a similar feeling of congestion, the documented underlying causes vary.

In this topic, you can read about both the external appearance of the nose and the condition of nasal breathing separately. In cases such as reconstructing the septum while addressing a dorsal hump and the nasolabial angle, both functional and aesthetic aspects are documented in a single surgical record. Rather than assessing breathing improvements solely from before-and-after photos, please review the patient's preoperative complaints, examination findings, the functional procedures performed, and the clinical progress described in the text.

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Nasal reconstruction when almost no septum remains after two nose surgeries — Before-and-after comparison
Before-and-after comparison

Nasal reconstruction when almost no septum remains after two nose surgeries

This is a case of septal cartilage deficit, nasal bone asymmetry, and nasal obstruction remaining after two surgeries. Through a closed approach, autologous rib cartilage was used for septal reconstruction, along with nasolabial angle correction, nasal bone asymmetry correction, and radix adjustment.

Preoperative condition · Postoperative record

Why noses deviate and bulbous tips persist after double jaw surgery, and how rib cartilage septal reconstruction is performed — Before-and-after comparison
Before-and-after comparison

Why noses deviate and bulbous tips persist after double jaw surgery, and how rib cartilage septal reconstruction is performed

This is a case of septal damage, a deviated nasal bridge, a bulbous nose, and nasal obstruction following double jaw surgery and two prior rhinoplasties. Autologous rib cartilage septal reconstruction, cartilage repositioning, lateral osteotomy, and functional nasal surgery were performed.

Preoperative condition

Why a high radix makes the nose look long and overly prominent — Before-and-after comparison
Before-and-after comparison

Why a high radix makes the nose look long and overly prominent

Following prior surgeries, a bulbous and drooping long nose with an excessively high radix and nasal obstruction was corrected using a closed approach. Scar tissue debridement, osteotomy, nasolabial angle correction, and septoplasty were performed concurrently.

Preoperative condition

Why noses become short and upturned after multiple revision surgeries, and methods for reconstruction — Before-and-after comparison
Before-and-after comparison

Why noses become short and upturned after multiple revision surgeries, and methods for reconstruction

A case correcting an upturned nasal tip caused by loss of the septum from repeated revision surgeries. Autologous rib cartilage septal reconstruction, nasal mucosal advancement flap, silicone implant adjustment, and rhinitis surgery were performed concurrently.

Preoperative condition · Postoperative record

Why the nasal tip can look bulbous and crooked after rhinoplasty with ear cartilage — Before-and-after comparison
Before-and-after comparison

Why the nasal tip can look bulbous and crooked after rhinoplasty with ear cartilage

This is a revision rhinoplasty case where the patient experienced a drooping tip, a deviated septum, and nasal obstruction after previous surgery. The septum was reconstructed using autologous rib cartilage, and silicone implant replacement along with rhinitis surgery was performed using a closed approach.

Preoperative condition · Postoperative record

Why a operated nose deviates and nostrils become asymmetric after physical trauma, and how septal reconstruction is performed — Before-and-after comparison
Before-and-after comparison

Why a operated nose deviates and nostrils become asymmetric after physical trauma, and how septal reconstruction is performed

A case where post-surgical trauma caused a septal tear, resulting in a crooked nose and nostril asymmetry. Septal reconstruction was performed using autologous rib cartilage, along with realigning the columellar central axis and replacing the implant.

Preoperative condition

Why the nasal tip elongates and droops years after rhinoplasty, and how to correct it — Before-and-after comparison
Before-and-after comparison

Why the nasal tip elongates and droops years after rhinoplasty, and how to correct it

A case involving a long, drooping nasal tip and nasal obstruction following previous rhinoplasty with a silicone implant and septal cartilage. The nasal tip was corrected using autologous rib cartilage, performed concurrently with septoplasty, inferior turbinate reduction, and synechia adhesiolysis.

Preoperative condition · Postoperative record

Why a nose operated on twice looks long and drooping, and how septal reconstruction using rib cartilage is performed — Before-and-after comparison
Before-and-after comparison

Why a nose operated on twice looks long and drooping, and how septal reconstruction using rib cartilage is performed

A revision rhinoplasty case where the septum was depleted due to excessive cartilage use in prior surgeries. The septum was reconstructed using autologous rib cartilage, a cartilage fragment on the bridge was removed, and silicone implant replacement was combined with osteotomy.

Preoperative condition

Why a short, upturned nose makes the philtrum look long and septal extension graft — Before-and-after comparison
Before-and-after comparison

Why a short, upturned nose makes the philtrum look long and septal extension graft

We extended the septum with autologous rib cartilage and corrected the nasolabial angle to improve an upturned nasal tip and a long philtrum. Lateral osteotomy, a custom silicone implant, and rhinitis surgery were performed concurrently.

Postoperative record

Changes that occur when an implant is positioned high and deviated: methods for replacement and bulbous tip correction — Before-and-after comparison
Before-and-after comparison

Changes that occur when an implant is positioned high and deviated: methods for replacement and bulbous tip correction

A high, deviated silicone implant was replaced to lower the radix, and septal extension was performed using donor rib cartilage. Partial soft tissue resection, cartilage tie, and rhinitis surgery addressed the bulbous tip and nasal obstruction.

Preoperative condition

Why a nose looks more crooked with facial asymmetry and how to correct it — Before-and-after comparison
Before-and-after comparison

Why a nose looks more crooked with facial asymmetry and how to correct it

Residual facial asymmetry and a deviated septum following double jaw surgery were corrected using autologous rib cartilage reconstruction. Lateral osteotomy, precision carving of a silicone implant, and rhinitis surgery were performed concurrently.

Preoperative condition · Postoperative record

Why the nasal tip deviates to one side after rhinoplasty and methods for reconstructing its support structure — Before-and-after comparison
Before-and-after comparison

Why the nasal tip deviates to one side after rhinoplasty and methods for reconstructing its support structure

Septal cartilage damaged from previous surgeries was reconstructed using autologous rib cartilage, and the lower lateral cartilages were restored. Lateral osteotomy and rhinitis surgery were performed concurrently to correct the crooked nose and nostril asymmetry.

Preoperative condition · Postoperative record

Why the nose looks long and the nostrils look pinched after multiple rhinoplasties — Before-and-after comparison
Before-and-after comparison

Why the nose looks long and the nostrils look pinched after multiple rhinoplasties

Lost lower lateral cartilage was reconstructed using autologous rib cartilage, and asymmetric, pinched nostrils were corrected. By lowering the radix, the appearance of a long nose was reduced, and surgery for rhinitis and nasal valve stenosis was performed concurrently.

Preoperative condition · Postoperative record

Why contracture remains in multiply operated noses: Reconstructing the columella and support framework — Before-and-after comparison
Before-and-after comparison

Why contracture remains in multiply operated noses: Reconstructing the columella and support framework

Contracture and septal defect resulting from repeated surgeries were reconstructed using autologous rib cartilage. For the retracted columella, retroauricular free skin flap grafting and perichondrium grafting were performed to restore its shape.

Preoperative condition

Nasal obstruction from a severely deviated septum: why cartilage reconstruction is necessary — Before-and-after comparison
Before-and-after comparison

Nasal obstruction from a severely deviated septum: why cartilage reconstruction is necessary

In a primary rhinoplasty patient, a severely deviated septum was reconstructed using autologous rib cartilage, and hypertrophied inferior turbinates were reduced. Dermis was grafted into the depressed alar region, and the nasolabial angle was adjusted.

Preoperative condition

Why a dorsal hump looks prominent and how to correct it along with the nasal tip — Before-and-after comparison
Before-and-after comparison

Why a dorsal hump looks prominent and how to correct it along with the nasal tip

Previously injected nasal filler was removed, the protruding dorsal hump was rasped, and lateral osteotomies were performed. The blunt nasal tip was elevated using autologous rib cartilage, and both the nasolabial angle and septum were corrected.

Preoperative condition · Postoperative record

Why nostrils become asymmetrical and the nose looks crooked, and how rib cartilage reconstruction is performed — Before-and-after comparison
Before-and-after comparison

Why nostrils become asymmetrical and the nose looks crooked, and how rib cartilage reconstruction is performed

Nostril asymmetry caused by a tilted columellar axis and loss of alar cartilage after Gore-Tex insertion was corrected through Gore-Tex removal, autologous rib cartilage alar reconstruction, and septoplasty.

Preoperative condition · Postoperative record

Why a multiply operated nose deviates and develops a widened tip, and how cartilage is reconstructed — Before-and-after comparison
Before-and-after comparison

Why a multiply operated nose deviates and develops a widened tip, and how cartilage is reconstructed

Following three prior procedures, a deviated nose caused by septal damage and a missing right lower lateral cartilage was restored through autologous rib cartilage structural reconstruction, silicone implant replacement, nasolabial angle correction, and rhinitis surgery.

Preoperative condition · Postoperative record

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Common questions before reading the cases

Are all cases of rhinoplasty with nasal obstruction caused by a deviated septum?

This list is organized around the complaint of nasal obstruction and does not attribute it to a single cause. Primary surgery cases document nasal obstruction secondary to a deviated septum, while other revision rhinoplasty records detail severe right-sided nasal obstruction resulting from postoperative intranasal mucosal adhesions. Even among cases found under the same search criteria, it is important to review the patient's reported symptoms and diagnostic findings individually.

Are there records that address both nasal appearance and nasal obstruction simultaneously?

Yes. In the record of a patient whose primary complaint was functional discomfort, severe septal deviation required intraoperative septal reconstruction, which was performed using autologous rib cartilage while addressing the dorsal hump and nasolabial angle. Because cosmetic changes in photographs do not directly reflect breathing status, please compare the images with the text describing which functional procedures were performed.

Related topics to explore

Deviated septumNasal valve stenosis and collapseRhinitis and inferior turbinate hypertrophyScar tissue and adhesionSeptoplasty

Surgical records referenced in this guide

  • Why a crooked nose and dorsal hump appear together, and how to approach male rhinoplasty
  • How to correct nasal obstruction and a wide, spread-out nose
  • Why a dorsal hump often comes with nasal obstruction, and how it is corrected using only autologous rib cartilage
Original article

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