Nasal Tip Remodeling for Bulbous Nose and Drooping Columella Correction

An East Asian bulbous nose is usually due to thick skin, but in some cases the alar cartilages are also large and drooping.

In such cases, the alar cartilages are well developed, and the nasal tip appears thick, making the nose look large and long.

Bulbous nose in a case with highly developed alar cartilages

At this time, the angle formed by the upper lateral cartilage and the alar cartilage is called the resting angle, and in a bulbous nose this angle is widened.

Because the alar cartilage is large, the nose has the shape of a bulbous nose, making the nasal tip appear thick.

The inner crura of the alar cartilage form the columella, and when this cartilaginous part descends lengthily, it is called a hanging columella.

A hanging columella caused by the descended medial crura of the alar cartilage

When the columella is descended, the nose appears longer and gives an unrefined impression.

To improve the shape of the nasal tip, septal cartilage was harvested.

Harvested septal cartilage

To remodel the alar cartilage, a support structure is needed to hold the cartilage together, and septal cartilage is an excellent material for this.

The remodeling process of the alar cartilage

First, a nasal tip support is created using the harvested septal cartilage.

Then, the size of the alar cartilage is adjusted, and various techniques are used to reduce the resting angle formed by the upper lateral cartilage and the alar cartilage.

Correction of the hanging columella (columella lifting)

Next, the medial crura of the alar cartilage are lifted and fixed to the septal cartilage, which serves as the support for the nasal tip. Through this method, the hanging columella is corrected.

Nasal tip remodeling refers to the process of adjusting the size of the alar cartilage and reducing the resting angle formed by the upper lateral cartilage and the alar cartilage to make the nasal tip look slimmer.

For this process, septal extension at the nasal tip is essential, because a support is needed to secure the remodeled alar cartilage.

And the columella lifting technique is a procedure that lifts and fixes the descended medial crura of the alar cartilage upward.

Comparison before and after 3 months following alar cartilage remodeling surgery

The thick nasal tip before surgery became smaller and changed into a sharper, more lifted appearance.

Comparison before and after 3 months following alar cartilage remodeling and columella lifting surgery

The hanging columella of the nasal tip was lifted upward, so the nose does not look long, creating a refined appearance.

Nasal tip remodeling is a surgical method that also adjusts the size and angular shape of the alar cartilage that makes up the nasal tip, and it is effective for bulbous noses with large alar cartilages.

Columella lifting is a surgical method that lifts and fixes the descended medial crura of the alar cartilage that form the hanging columella.

This is a real model who consented to disclosure.