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Drooping tip and hooked nose: looking beyond height to underlying structural support

This is page 8 of cases on drooping tip and arrow nose: looking beyond height to structural support. Review surgical records and before-and-after photos for cases 127–144 of 166.

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Bulbous nose correction and lowering the columella — Before-and-after comparison
Before-and-after comparison

Bulbous nose correction and lowering the columella

To improve a retracted columella and a bulbous nose resulting from past alar reduction, filler on the nasal bridge was removed, and autologous rib cartilage was used for septal extension, lowering the columella, and nasolabial angle correction.

Preoperative condition · Postoperative record

Methods for correcting a bulbous and wide nose — Before-and-after comparison
Before-and-after comparison

Methods for correcting a bulbous and wide nose

A wide nasal tip, wide nasal bones, and nasal obstruction caused by internal nasal valve stenosis were improved together using closed lateral osteotomy, partial resection of subcutaneous tissue, and septal cartilage reinforcement.

Preoperative condition · Postoperative record

Custom rhinoplasty method for replacing an unnatural silicone implant — Before-and-after comparison
Before-and-after comparison

Custom rhinoplasty method for replacing an unnatural silicone implant

With an unnatural implant outline and a crooked nose, the existing implant was removed and replaced with a wider implant, while autologous rib cartilage was used to lower the columella alongside osteotomy.

Preoperative condition

Support structures and correction methods for a drooping nasal tip — Before-and-after comparison
Before-and-after comparison

Support structures and correction methods for a drooping nasal tip

Through a closed approach, a drooping tip, bulbous nose, and dorsal hump were refined into smooth lines using autologous rib cartilage tip plasty and silicone implant placement.

Preoperative condition · Postoperative record

Surgical approach for a collapsed nose caused by septal cartilage damage — Before-and-after comparison
Before-and-after comparison

Surgical approach for a collapsed nose caused by septal cartilage damage

In a nose where most of the septum and alar cartilages were lost after two previous surgeries, we reconstructed the overall framework using autologous rib cartilage, removed contracture tissue, and corrected the nasolabial angle.

Preoperative condition · Postoperative record

How to lower a high radix — Before-and-after comparison
Before-and-after comparison

How to lower a high radix

In a patient presenting with an excessively high radix, a drooping tip, and nasal obstruction, a closed approach was used to lower the starting point, reconstruct the nasal tip using autologous rib cartilage, and perform septoplasty.

Preoperative condition · Postoperative record

Correction methods for a pinched and retracted nostril — Before-and-after comparison
Before-and-after comparison

Correction methods for a pinched and retracted nostril

A case where the columella tilted to the left and nostril asymmetry worsened after a previous surgery. The columella was shifted to the right to reduce shape differences, and residual asymmetry remained due to congenital nostril size differences.

Preoperative condition · Postoperative record

Methods for correcting a dorsal hump and crooked nose — Before-and-after comparison
Before-and-after comparison

Methods for correcting a dorsal hump and crooked nose

This is a case of nasal bone deformity, a dorsal hump, and right-sided nasal obstruction following closed reduction for a nasal bone fracture. After confirming depression of the right nasal bone on CT, osteotomy and septal reconstruction were planned, and the changes in nasal shape after surgery were documented.

Preoperative condition · Postoperative record

How to correct a dorsal hump and crooked nose — Before-and-after comparison
Before-and-after comparison

How to correct a dorsal hump and crooked nose

This is a case of a dorsal hump with a large skeletal framework and a high radix, accompanied by nasal deviation and a drooping tip. Considering facial proportions, the surgery was completed without implants, and changes in the dorsal hump, columella, and tip shape were documented.

Preoperative condition · Postoperative record

Methods for correcting a drooping nose — Before-and-after comparison
Before-and-after comparison

Methods for correcting a drooping nose

This is a case where the lower edge of the silicone implant along the nasal bridge became visible as the nasal tip drooped. We planned an implant exchange and autologous rib cartilage reinforcement, documenting post-operative changes in the nasal tip, nasolabial angle, and nasal bridge line.

Preoperative condition · Postoperative record

How to correct nasal obstruction and a wide, spread-out nose — Before-and-after comparison
Before-and-after comparison

How to correct nasal obstruction and a wide, spread-out nose

This is a case where mucosal adhesion, septal deviation, and tip deformity were identified following previous surgeries. We planned support reinforcement using autologous rib cartilage along with functional surgery, and recorded the postoperative changes in columellar and nostril asymmetry.

Preoperative condition

How to correct a bulbous, drooping nose — Before-and-after comparison
Before-and-after comparison

How to correct a bulbous, drooping nose

For a drooping, bulbous nose caused by glabella filler and bony asymmetry, the filler was removed, and refinement was achieved through lateral osteotomy, septal extension, and a thin silicone implant.

Preoperative condition · Postoperative record

Surgical approach to reconstructing a contracted nose after severe inflammation and partial skin necrosis of the nasal tip — Before-and-after comparison
Before-and-after comparison

Surgical approach to reconstructing a contracted nose after severe inflammation and partial skin necrosis of the nasal tip

This is a case of recurrent inflammation leading to partial skin necrosis, a depressed scar, and contracture deformity of the nasal tip. After stem cell therapy, revision surgery was performed with a surgical plan including septal reconstruction, lowering the nostril rims, and dermal grafting.

Preoperative condition · Postoperative record

How to plan nostril lowering (alar rim grafting) in an upturned nose — Before-and-after comparison
Before-and-after comparison

How to plan nostril lowering (alar rim grafting) in an upturned nose

A case where a septum weakened by previous surgery was reinforced with donor rib cartilage, and nostril lowering was performed using an ear cartilage graft and lower lateral cartilage repositioning. The existing autologous gluteal dermis was reused at the nasal tip, and functional surgery for nasal obstruction was performed simultaneously.

Preoperative condition

Surgical method for correcting a drooping nose (implant-free) — Before-and-after comparison
Before-and-after comparison

Surgical method for correcting a drooping nose (implant-free)

This is a case of implant-free rhinoplasty addressing a mild dorsal hump, a long, drooping tip, and an apparently crooked nasal bridge. Donor rib cartilage was partially filled along the nasal bridge, and the postoperative changes in the nasal tip, nasolabial angle, and nasal bridge line were documented.

Preoperative condition

How to correct a bulbous, drooping long nose — Before-and-after comparison
Before-and-after comparison

How to correct a bulbous, drooping long nose

This is a case of correcting a bulbous and drooping long nose caused by thick, broad tip skin. A portion of the subcutaneous tissue beneath the nasal tip skin was removed, and the nasal tip height, the starting point at the glabella, and the drooping columella shape were adjusted.

Preoperative condition

How to reconstruct a columella retracted by contracture — Before-and-after comparison
Before-and-after comparison

How to reconstruct a columella retracted by contracture

Loss of the septum and retraction of the columella caused by inflammation and contracture were restored with three-dimensional definition through total autologous rib cartilage reconstruction and lowering the columella.

Preoperative condition · Postoperative record

Methods for correcting a drooping and crooked nose — Before-and-after comparison
Before-and-after comparison

Methods for correcting a drooping and crooked nose

This is a case where the nasal tip began drooping and deviating to the left after surgery with donor rib cartilage, raising suspicion of partial resorption. Nasal reconstruction and septal extension using autologous rib cartilage were planned, and immediate postoperative changes in the nasal tip and nasolabial angle, as well as the limitations of asymmetry correction, were documented.

Preoperative condition · Postoperative record

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