[Nose Surgery Review] A Case Review of Short Nose Rhinoplasty with a Low Nose and Upturned Tip

Recently, as eye and nose plastic surgery has become more common, many people think that there is not much difference between hospitals.

However, not only eye surgery but also nose surgery has various cases depending on the type,

and in particular, there are not a few cases where several types appear in combination.

Therefore, rather than choosing a hospital by relying only on type-specific nose surgery reviews,

it is preferable to accurately understand your own nose condition and choose a hospital by referring to cases in which surgery was performed accordingly.

Today, I would like to introduce a surgical case of someone who was concerned about a short nose with a low nasal bridge and highly visible nostrils.

Short nose

First nose surgery, short nose + crooked nose surgery performed (before surgery 2020.06.27)

Medically speaking, a short nose refers to a shape in which the nasal tip is turned upward, making the nostrils relatively visible from the front.

The ideal nasolabial angle for women is 95 to 110 degrees,

and for men it is around 90 to 95 degrees,

and generally, 90 to 100 degrees is considered appropriate.

However, in the case of a short nose, the nasolabial angle may exceed 105 to 110 degrees.

People concerned about a short nose often say during consultations,

“My nose is low, but it seems like my nostrils are very visible.”

In fact, one cause of highly visible nostrils is a short nose,

but it cannot be concluded that a nose is definitely short just because the nostrils are highly exposed.

When the alar rim is significantly drooped (left), a nose in which the lateral cartilage is pinched and raised into a V shape (right)

Source: TS Plastic Surgery website

Even if it is not a short nose, there are cases where the nostrils are highly visible.

A representative example is when the alar rim is significantly drooped, or when the lateral cartilage is compressed and the nose is raised upward in a V shape. In such cases, simply raising the nasal tip may not be enough to improve the appearance. For these situations, a more comprehensive surgical plan is needed, and a customized approach that considers the overall nasal structure is important.

Pre-surgery features

First nose surgery, short nose + crooked nose surgery performed (before surgery 2020.06.27)

Even among short noses, there are differences in severity.

In the case of the patient introduced today, it was not a severely short nose.

Looking more closely,

1. From the front, the nose appeared somewhat spread out to both sides, and although the face itself was not large, the overall impression was somewhat flat and the facial axis was not clearly defined.
2. From the side, the patient’s mouth was not severely protruded, but due to the low nasal bridge and lack of nasal volume, the mouth appeared relatively protruded.

Surgical plan

1. Raise the nasal tip with septal extension surgery
2. Correct the nasal bridge into a straight, moderately high line using silicone

Key points of short nose surgery

1. Skin condition

People with short noses generally feel that the nose is low and the tip is upturned, so during surgery they often want the tip to be raised as much as possible and the upturned direction of the tip to be brought downward.

However, because elasticity varies depending on the skin condition, there is a limit to how much can be raised. Therefore, within the range allowed by skin elasticity, it is very important to sufficiently raise the nasal tip and adjust the upturned direction downward.

During consultation, the skin should be gently pulled to carefully check how far it can stretch and how much surgical adjustment is possible, and then a safe and effective surgical plan should be established accordingly.

2. Checking the size of the septum

Preoperative CT images to check the size of the septum (reference images)

Source: TS Plastic Surgery

The most effective material for raising the nasal tip is septal cartilage.

The reason septal cartilage is considered ideal for nasal tip surgery is that it is thick, sufficiently long, and not curved.

However, in the case of a short nose, the septal cartilage itself is often small and short, which may limit how much the nasal tip can be raised as desired. Therefore, it is very important to check the size and condition of the septal cartilage in advance through preoperative CT imaging, etc.

If the patient wants a glamorous, voluminous nose but there is not enough septal cartilage available, auxiliary materials such as ear cartilage or donated rib cartilage can be considered. In such cases as well, establishing an appropriate material choice and surgical plan through sufficient preoperative consultation can lead to safe and satisfying results.

Progress observation

First nose surgery, short nose + crooked nose surgery performed (9 days after surgery)

At 9 days after surgery, a slight yellow bruise remains around the nose, but it appears to be in a state where there is not much inconvenience in daily life.

In this surgery, by sufficiently raising the nasal tip, it is possible to see that the width of the nose naturally became narrower without separate alar reduction.

From the side as well, the nasal tip and the mouth form a similar line, so the mouth does not appear excessively protruded, and as the upturned nasal tip comes down, the nasolabial angle also improves to be close to the normal range. As recovery progresses and swelling and bruising gradually subside, even more natural changes can be expected.

First nose surgery, short nose + crooked nose surgery performed (1 month after surgery, 2020.07.27)

As you can see in the photo, the dorsal aesthetic line and the line of the nose itself are preserved, so even with the eyes covered, natural shading appears on the nasal bridge, making the face look more three-dimensional, and creating a more balanced impression.

First nose surgery, short nose + crooked nose surgery performed (9 months after surgery, 2021.03.27)

Even after 9 months, it can be seen that the nasal tip has not sagged and the shape has been well maintained.

When the dissection is sufficiently secured and the nose is raised, a result can be expected in which the shape of the nasal tip does not collapse over time and remains stable.

Today, I reviewed a short nose case among various nose types.

The most important point in short nose surgery is

accurately identifying the patient’s skin elasticity and characteristics, then setting the possible range of height. If surgery is performed with sufficient dissection, the pretty appearance immediately after surgery can be maintained for a long time.

In addition to skin elasticity, skin thickness must also be considered. If the skin is thin and the nose is made excessively high, the implant may become visible at the nasal tip or bridge, so the surgical plan should be made after carefully analyzing skin elasticity and thickness during consultation. For a satisfying result, the patient also needs to communicate sufficiently with the medical team and accurately understand the characteristics of their own nose. Through smooth communication with the medical team, I hope you can establish a surgical plan that suits you and expect a more satisfying result.

※ Depending on the individual, side effects such as inflammation, bleeding, and nerve damage may occur, so sufficient consultation with the medical team is necessary before surgery.