Nose Bridge Starting Point Lowering – Noselab Dr. Chayoung Kang

Today we have a case of a corrective surgery on a patient whose glabella had become too high after having surgery, which made her eyes look too fierce and close together. The nose was long and overall bent to the right side. Before the surgery, she said that the nose starting point and the nose bridge were too hight, which made it look unnatural.

Preoperative Consultation

FRONTAL VIEW

  • The space between the eyebrows was too high.
  • The nose was bent to the right side.
  • The nostrils were too visible and asymmetric.
  • The nose looked too long.

SIDE VIEW

  • The union between the forehead and the glabella looked very unnatural.
  • The nose tip was short and droopy.
  • The columella looked retracted and the alar was descending.
  • The nasolabial angle was big.

Preoperative consultation design. Nasal base view.

NASAL BASE VIEW

  • The nostrils were asymmetric
  • The columella was tilted to the right side.
  • The columella was too thin.

To improve each of these problems, I established the following plan:

Surgery Plan

  • The space between the eyebrows was too high. Lowering the starting point to the pupil line
  • The nose was bent to the right side. ➜ Outer osteotomy
  • The nostrils were too visible and asymmetric.➜  Deviated septum correction using self-rib cartilage
  • The nose looked too long. ➜  The lowering of the starting point is expected to correct the lenght of the nose.
  • The columella looked retracted and the alar was descending.Correction of the nasolabial angle to an approximate 95° angle by lowering the columella using the self-rib cartilage.
  • The columella will be expanded, and the slant will be improved sufficiently only with the septal correction.

Before and After Surgery Photos

The surgery went as expected in the preopreative plan, and the results were satisfactory. When observing the frontal photos after the surgery, we can see that the glabella starting point was given a more natural appearance. The Gore-tex that had been inserted in the nose bridge was cleanly removed in its entirety. The bumpy parts on the nose bridge were improved as well, and the nose tip height was meticulously increased.

Photo of the Gore-tex removed

Before and After Surgery Photos. Before surgery (left), after surgery (right)
Before and After Surgery Photos. Before surgery (left), after surgery (right)

When seen from the front, the glabella was leaning too much to the right, but right after the surgery it could be observed to have improved significantly, and the nostril asymmetry was definitely improved.

Before and After Surgery Photos. Before surgery (left), after surgery (right)

The most dramatic part is the change in the nostrils. Since there was a sever leaning to the right side, the columella was moved to the center to gove the nose a natural appearance and improve the nostril asymmetry.

Before and After Surgery Photos. Before surgery (left), after surgery (right)
90° angle | 45° angle | Frontal view. Photos taken after the surgery with the consent of the patient.
Photo of the nostrils after surgery.

By looking at the before and after surgery photos, the enlogated appearance was reduced significantly, and they look wider, changing the image to be more natural-looking.

Today we discussed about the lowering of the nose strating point. I hope this text will be helpful for those who are thinking about having a revision rhinoplasty.

Dr. Chayoung Kang

Director of Noselab Clinic

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