Hello, I am Dr. Chayoung Kang, Director of Noselab Rhinoplasty Clinic.
Today we will introduce the rhinoplasty case of a patient who had a rhinoplasty with a very obvious implant that made the nose look deviated. He wanted a natural and attractive nose, so I planned the surgery after analyzing the patient’s face and nose in order to achieve general balance.
Preoperative Design Consultation
Let’s analyse the preoperative condition of the patient in detail:
- Slightly deviated nose
- The columella and the nose tip looked too elevated in comparison to the nasal alar.
- Prominent nostril asymmetry.
- Dent on the upper right side of the nostril.
- Prominent nasal hump
- Droopy nose tip
- Barely visible columella
- Big nasal alar
- Evident implant.
- Noticeable nasal deviation.
- Noticeable nostril asymmetry.
- The nose tip slightly tilted to the right side.
Surgical Content
The surgery proceeded through the closed rhinoplasty approach as follows:
a) Nose tip correction: Using the autologous costal cartilage, we planned a septal extension graft to straighten the bent nose tip.
b) Descending the columella and correcting the nasolabial angle: After correcting the septal cartilage and relocating the alar cartilage, we corrected the nasolabial angle and lowered the columella in a natural-looking way.
c) Reconstruction of the right alar cartilage: We corrected the depressed area and reconstructed the right side alar cartilage that we had suspected was damaged.
d) Outer osteotomy: We performed a delicate osteotomy operation to straighten the deviated nose.
e) Replacing the implant: Removing the existent implant and inserting a wider implant under the periosteum in order to make it less obvious.
f) Septoplasty: Correcting the deviated septum and increasing the stability of the nasal structure to improve the breathing function.
g) Submucosal resection of the turbinates: Using a high-frequency laser to remove tissue from the thick inferior turbinates, to boost the improvement of rhinits.
Before and After Surgery Photos
By comparing the before and after surgery photos we can see the following improvement points:
- Correction of the diagonal deviated nose.
- The nose tip that was higher than the alar was improved.
- The nostril asymmetry was greatly improved.
- The dent on the upper right side of the alar was corrected naturally.
- The hooked nose was transformed to a soft straight nose.
- The droopy nose tip was adjusted upwards and the balance improved.
- The columella was lowered and the nose shape became more harmonious.
- The implant became less obvious and the contour of the nose looks more natural.
- The nose shape looks smoother.
- The nostril asymmetry improved signficantly.
- The tilted nose tip took on a more balanced look.
- The dent on the right side of the alar was corrected in a natural-looking manner.
After surgery table photos
Overview
I believe the most important part of this surgery is descending the columella in a natural-looking manner. The columella plays an important role in the overall shape of the nose. It is not a part that catches the eye, but if the columella is out of place, the appearance becomes strange. In this surgery, the septal cartilage correction, the alar cartilage repositioning, and lowering the columella through a nasolabial angle correction using self-rib cartilage were successful.
Moreover, in the case of patients whose skin is thin, the method to solve the visibility of the implant issue is a difficult part. There are many cases where the height of the bridge needs to be lowered, but thankfully for this patient’s case we did not need to reduce the height to obtain good results. This time the implant was wider and was adjusted meticulously.
Deviated nose correction, improvement of a nasal hump, correction of a dent on the alar, treatment for rhinitis, and others are problems that can be solved at the same time while getting natural results are the advantages of the closed rhinoplasty approach. This method minimizes scarring and ensures a short recovery period.
I hope this blog is helpful for those who are concerned with an obvious implant.
Noselab Rhinoplasty Clinic
Dr. Chayoung Kang.
