Rhinoplasty for a Low and Short Nose

* Basic Information

- Female in her 20s

- Very low nasal bridge

- Short and upturned-looking nose

- Blunt nasal tip (Bulbous nose)

* Consultation

1. The patient visited due to a very low bridge and short nose, which made her face appear wide and flat like a ‘concave plate’.

2. We also needed to improve the blunt impression caused by the bulbous nose, right?

3. In the pre-operative CT scan, the septal cartilage was found to be too small to be used alone. Therefore, we planned the surgery using a combination of the septum, ear cartilage, and additional donated rib cartilage.

* Plan

1. Bridge Rhinoplasty (Silicone implant)

2. Tip Rhinoplasty

- Donated rib cartilage (Septal extension graft to correct the short nose)

- Septum & Ear cartilage (Columellar strut graft + Onlay graft)

- Correction of short and bulbous nose

* Post-operative Progress

1. The patient was very satisfied as the sleek bridge line added three-dimensionality to her previously flat face, making it appear smaller.

2. To correct the short nose, donated rib cartilage, septal cartilage, and ear cartilage were all utilized. I believe the result is highly successful because I focused on creating strong support across all vectors to ensure the tip does not droop or become short again. ^^

3. By removing some of the blunt tissue at the tip and raising it sharply, the bulbous nose was sufficiently corrected. Overall, she now has a very sophisticated impression :)

* Key Points

1. For short nose correction, ‘sufficient dissection of skin and cartilage’ and ‘formation of a sturdy support’ are essential. Very tough ligaments hold the cartilage together like glue; to correct a short nose, it is vital to release these ligaments sufficiently and then build a firm support to prevent it from returning to its original state.

Looking at the anatomy of the nose below will be helpful!

2. Think of a ‘sturdy support’ like a camera tripod. When performing short nose surgery like this, the downward extending force and the upward lifting vector of the tip meet to create a solid framework!

3. Regarding the use of donated rib cartilage, opinions vary among both patients and surgeons. While I do not unconditionally recommend or insist on its use, I believe it is a good option when truly necessary.

4. The biggest concerns with donated rib cartilage are inflammation and tip drooping. Since it is a foreign material, the probability of inflammation may be slightly higher compared to using only autologous cartilage. Also, depending on the absorption rate, the tip may unexpectedly droop or warp.

5. However, I believe these issues mostly occur when the tip is raised excessively beyond what the individual can handle, or when factors like smoking play a major role. Therefore, if a proper surgical plan is established and factors that negatively affect the nose—such as smoking—are avoided, donated rib cartilage is a sufficiently good and sometimes necessary material.

Consultations and surgeries should be performed by a plastic surgery specialist!

Stay healthy and beautiful today :)

Right Thinking, Right Plastic Surgery - Yu Young-moon

Complications and side effects such as bleeding, inflammation, infection, and asymmetry may occur after surgery depending on the individual, and caution is required.