Hello, this is Dr. Chayoung Kang, Director of Noselab Rhinoplasty Clinic. Today, we will introduce a corrective rhinoplasty case of a patient whose nose became deformed after undergoing jaw surgery.
This patient visited our Noselab because she was dissatisfied with her nose despite undergoing several rhinoplasty surgeries and jaw surgeries.
Preoperative Design Consultation
Patient’s surgical history
– 2014: Septal cartilage + ear cartilage + nose tip reduction
– 2018: Autologous costal cartilage + alar reduction
– 2022: Double-jaw surgery
- The nose appears to be bent to the right (the implant is bent to the right)
- Severe nostril asymmetry (effect of two nostril reduction surgeries)
- High starting point
- Long nose
- Droopy nose tip
- High starting point
- Protruding mouth after undergoing jaw surgery
- Prominent deviation and long nose
- Nose tip asymmetry
- Severe nostril asymmetry
- The base of the right nostril is excessively wide.
Additional findings
- Symptoms of nasal congestion on the left side.
- Septal cartilage deviation to the left as seen through the CT scan and intranasal endoscopy.
Surgical details
The following surgeries were performed through closed rhinoplasty.
a) Autologous costal cartilage harvesting and transplant:
- Harvesting of the autologous rib cartilage to use it to reconstruct the septal cartilage.
- Previously used autologous costal cartilage (very thin and small) reused for nasal alar cartilage reconstruction.
b) Septal reconstruction and plastic surgery:
- Restoration of the anterior nasal spine removed due to the jaw surgery
- Firm fixing of the detached lower surface of the septal cartilage to the upper jaw.
- This process was the most difficult and important part.
c) Nasal alar cartilage reconstruction:
- Reconstruction of the damaged alar cartilage on both sides using the previosuly used autologous costal cartilage
- Improvement of the nostril asymmetry by repositioning the alar cartilage and tying it in the center.
d) Nose bridge implant replacement:
- Removal of current implant
- Lowering of the starting point and insertion of a new silicone implant
e) Correction of non-squint angle:
- Removal of the existing cat surgical prosthesis
- Correction of the nasolabial angle using the self-rib cartilage
f) Reduction of the nasal base:
- Reduction of the right nostril base to create a more balanced shape for the nostrils on both sides.
- Overall reduction of the width of the nose.
Before and After Surgery Photos
- Correction of the deviated nose.
- Improvement of the severe nasal asymmetry.
- Lowering of the high starting point.
- Adjustment of the lenght of the nose.
- Raised the nose which previously looked droopy.
- By lowering the starting point, the shape of the nose became more natural.
- Through the improvement of the protruding mouth the face became more balanced.
- The shape of the nose became softer after the nasal deviation correction.
- Improvement of the mouth protrusion.
- Great improvement of the severe nostril asymmetry.
- By reducing the width of the right nostril base, the balance between both nostrils improved.
After surgery table photos
Overview
The level of difficulty of performing rhinoplasty after double jaw surgery can greatly vary depending on the type of jaw surgery method employed. In cases like this patient, where the bottom of the septum cartilage is completely detached from the upper jaw bone and the anterior nasal spine had been completely removed, the difficulty of the surgery increases significantly. In such cases, the stability of the tip of the nose decreases, and the shape of the nose may become worse over time. Therefore, septal reconstruction surgery is absolutely necessary, but this reconstruction surgery itself is complicated and takes a lot of time.
Not all rhinoplasty after jaw surgery is this complicated, but some cases require very high-level surgical techniques. In this case, we had to solve complex problems at the same time, such as septum reconstruction, alar cartilage reconstruction, and nose base reduction.
In particular, the key to this surgery was to fix the septal cartilage to the maxilla during the septal reconstruction process. Since this process was successful, we were able to secure structural stability of the nose and create the tall and magnificent nose shape that the patient desired.
Securing sufficient cartilage through reuse of autologous costal cartilage and harvesting of new autologous costal cartilage also played an important role in achieving good results. Through this, we achieved improvements in various areas such as septal reconstruction.
With Noselab Rhinoplasty Clinic you can achieve a beautiful and healthy nose.
Thank you.
Noselab Rhinoplasty Clinic
Dr. Chayoung Kang.
