Hello, this is Dr. Chayoung Kang, Director of Noselab Rhinoplasty Clinic. Today, we will introduce the case of a patient with right side nasal congestion, a droopy nose tip, and who wanted to lower the columella.
This patient had already undergone 2 previous rhinoplasty surgeries, this was her 3rd rhinoplasty.
Preoperative Design Consultation
Patient’s medical history:
- July 2022 – Rhinoplasty using ear cartilage and silicone.
- April 2023 – Rhinoplasty using autologous rib cartilage and silicone.
Photos before surgery
- Noticeable deviation
- Visible implant on the nose bridge
- Droopy nose tip
- Retracted columella
- Unnatural nasolabial angle
- Nostril asymmetry
- Tilted columella
Additional findings
- The patient complained about nasal congestion on the right side of the nose.
- Results of the CT scan and intranasal endoscopy examination:
- Septal deviation
- Thickened inferior turbinates
- Intranasal mucosal adhesion on the right side
Surgical Details
a) Autologous rib harvesting and transplant
- Reconstruction and reinforcement of the insufficient areas of the nasal structure by harevsting and using the patient’s own rib cartilage.
b) Septal extension graft
- Strenghtening and extension of the septal cartilage by using the autologous rib cartilage.
- Through this we can heighten and increase the support structure to elevate the droopy nose tip.
c) Replacement of the nose bridge implant
- Removal of the existing silicone implant and replacing it with a wider implant.
- Through this, we could improve the issue of the visible implant, and make the cotour more natural-looking.
d) Columella lowering
- Improvement by the overall nose contour though lowering the columella appropriately.
e) Septum surgery
- Straightening the deviated septum to improve the nasal congestion.
g) Mucous membrane adhesion peeling surgery
Improvement of the nasal congestion by peeling off the right intranasal mucous membrane adhesion.
h) Turbinate reduction
- Reducing the size of the thickened inferior turbinates using a high-frequency laser in order to improve the nasal congestion.
Every procedure was performed through the closed rhinoplasty approach, without leaving any external scars.
Before and After surgery photos
- Nasal deviation correction
- Great improvement for the issue of the visible implant.
- An overall more harmonious appearance.
- Balance improvement after raising the droopy nose tip.
- A more natural nose shape achived through the columella lowering.
- As the previously unnatural nasolabial angle was improved, the harmony between the lips and the nose became enhanced.
- A smoother nose shape after the deviation correction.
- Better and more natural contoured implant.
- As the nostril asymmetry improved, the appearance became more balanced,
- Straightening of the tilted columella.
After surgery table photos
Overview – nasal congestion improvement
This case is a good example of achieving both cosmetic and functional improvements. The patient had previously undergone two rhinoplasties, but was still dissatisfied with the results, especially with functional discomfort due to nasal congestion.
Septal extension using autologous costal cartilage played a major role in correcting the droopy nose tip and strengthening the overall structure of the nose. In addition, replacing the bridge prosthesis solved the problem of the prosthesis being too visible.
The overall balance and harmony of the tip of the nose and lips were improved through the correction of the nasolabial angle and the columella lowering. This went beyond simply changing the shape of the nose and played a significant role in improving the overall impression of the face. What is particularly noteworthy about this surgery is the comprehensive approach to solving the nasal congestion issues. The functional problems of were improved through septoplasty, mucosal adhesion peeling surgery, and inferior turbinate reduction surgery. This is where the expertise of an otolaryngologist shines.
By using a closed rhinoplasty approach, we were able to shorten the postoperative recovery period and complete the surgery without leaving a scar, which greatly contributed to increasing patient satisfaction.
I hope this case was helpful to those concerned about nasal congestion, and a droopy nose tip with an unnatural nasolabial angle.
With Noselab Rhinoplasty Clinic you can achieve a beautiful and healthy nose.
Thank you.
Noselab Rhinoplasty Clinic
Dr. Chayoung Kang.
