Functional Rhinoplasty + Columella Straightening – Noselab Dr. Chayoung Kang

Hello!

I am Dr. Chayoung Kang, the Director of Noselab Clinic.

The nose is important for cosmetic purposes, but its respiratory functionality is also extremely important. To a great extent, breathing comes naturally for most people, but for some others, breathing can be a source of suffering.

Therefore, today we will talk about making the nose more beautiful while also improving the breathing function. (Functional rhinoplasty)

Today’s patient visited the clinic to address a nasal congestion issue. Through the CT scan taken a year ago, we diagnosed septal deviation and hypertrophic rhinitis. Therefore, we perfomed a septal deviation correction and a turbinate submucosal resection using a high-frequency laser. We reduced the thick turbinates, and the overall nasal congestion improved. However, since the septal cartilage was too thin, and originally considereably bent, the septum was returning to its original crooked appearance. That is why we decided to improve the cosmetic parts while also performing a septal cartilage reconstruction surgery. (Functional rhinoplasty)

Preoperative Consultation

From the font, the nose tip was leaning ot the right side, the nostrils looked asymmetrical, and the alar on the left side had become hollow.

Frontal photo of the preoperative design

From the side profile, the nose tip appear to be drooping, and the boundary between the implant was visible.

Side profile preoperative design

The columella was leaning over the right side, and the septum inside the left nostril was significantly bending to the p[oint it was blocking the space inside the nostril.

Nostrils preoperative design

The preoperative CT scan findings show the septal cartilage (red) leaning to the side, and the left nostril interior space (black) could be seen vastly narrowed.

CT scans taken at our clinic showing the septal cartilage (red) leaning to the side and blocking the space inside the left nostril.

If the septal cartilage becomes significantly deviated, it has the most direct impact on the shape of the nose tip, including the columella. The direction of the deviated septal cartilage is can be seen to be identical to the tilting direction of the columella, and we believe it is also related to the nose tip pars also bending to the right side. Especially, if the columella is tilted, it is also accompanied by nostril asymmetry.

CT findings, the space inside the left nostril is not showing up, and photo of the nostrils where we can observe the location of the almost obstructed space inside the left nostril.

Surgery Plan

The surgery plan for this patient is to straighten the deviated septum. There are various methods to straighten a septal curvature. However, a deviated septum correction reoperation must be performed more cautiously since there is risk that the septum will become deviated again or that the cartilage would become weaker. And, especially, to improve this patient’s nose tip shape, we have to perform the correction with a stronger septal cartilage. That is why we decided to perform the septal cartilage reconstruction using self-rib cartilage as the surgery plan.

Before and After Surgery Photos

On the 90-degree side profile photos, the droopy nose tip was improved and the low columella was also improved in appearance as it was lifted.

Before surgery (left), after surgery (right)

From the front view, the nose tip that was leaning to the right side has improved significantly, and the asymmetrical appearance of the nostrils was improved.

Before surgery (left), after surgery (right)

The most visibly changed part is the nostrils. The columella that was tilted to the right side has now been straighten, and even thought it is not completely visible due to the cotton inside the nostrils, the photo is showing that the septal cartilage has been straightened as well.

Before surgery (left), after surgery (right)

Appearance after the surgery

Photos after the surgery. 90° angle | 45° angle | Frontal view

Nostril photo after the surgery

I hope this text is helpful for anyone who wants to fix nasal congestion while also making a beautiful nose shape.

Dr. Chayoung Kang

Director of Noselab Clinic

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