Bulbous Nose Surgery, a Real Review from an Aspiring Celebrity

Hello.

The doctor who teaches doctors I am Yoo Young-gi, a board-certified plastic surgeon.

Today, I have something exciting to brag about~! ^^

A foreign patient who had surgery gave me a precious gift along with a carefully written note in Korean, which they do not know how to write, thanking me for making them more beautiful.

With the mindset of operating on a family member, I carefully diagnosed what was aesthetically needed and performed the surgery meticulously, and thankfully the results were so good as well, so it seems we continue to stay connected rather than ending with just one surgery. ^^

Today, I’d like to talk about bulbous nose surgery. When performing surgery to improve a bulbous nose, I’d like to look at four important points to consider.

Based on an actual idol trainee’s case, let’s take a detailed look at the case analysis and see what is important.

Many people, while watching shining actors and idols on TV, have probably wondered, "I wonder if they also had plastic surgery?"

The public is well aware that actors and idols often choose plastic surgery in order to maintain a natural kind of beauty.

In reality, not only aspiring entertainers but also actors who have already made their names widely known visit plastic surgery clinics for a more attractive appearance.

At our clinic as well, not only trainees but also leading actors whom anyone would recognize by name come in during their break periods to have surgery, which shows that the desire to enhance one’s own appeal through plastic surgery has already become quite mainstream.

Let’s look at the case I’m introducing today.

An idol trainee who had become very popular through a dance audition selection program in Thailand and was approaching the final selection audition a few months later came to us with a surgical inquiry.

She was talented in every way, whether dancing or singing, without any area lacking, and her face was quite pretty as well,

but she had a severe complex about the shape of her nose, especially her blunt, bulbous nose.

However, her skin was so thick that it was a fairly difficult case to bring about a major change through surgery.

For reference, the thinner the nasal skin, the easier it is for bulbous nose surgery to turn out very well.

When the internal structures are carefully and beautifully refined, if the skin is thin, the refined shape shows through from the outside as well, which increases satisfaction with the surgery.

The thicker the nasal skin, no matter how much is shaved, raised, or refined inside, the thick skin wrapping over it again does not show the changes very well.

In other words, in cases like this, there are limits to bulbous nose surgery.

At the first consultation, she brought photos of celebrities whose nose shape she wanted, but the expectations were so far from reality that I remember immediately telling her that was not possible as soon as I saw them ^^;

Because depending on each person’s individual features, there are parts that can change through surgery and parts that cannot.

When someone says something that cannot be done can be done, it usually means either there is a lack of experience or it is an unethical case,

so it is fine to visit several places for consultations, but do not go around looking for the answer you want to hear; you need to judge carefully which place explains things accurately.

Let’s look at the appearance before surgery.

This patient had a very low nasal tip and bridge height, and because the nasal skin was so thick, I strongly emphasized lowering expectations for the surgery during the consultation.

I also explained several surgical options to the parents who came with her, about which direction would be best for the operation.

Among the four points to consider in this patient’s bulbous nose surgery, this was the first item to consider.

First, 1. the height of the nasal tip.

A nose shape that bulges outward can be expected to become flatter as the nasal tip is raised, because the skin on both sides of the nostrils is naturally pulled upward together.

At that point, you need to decide how much to raise the nasal tip. That is because this determines what materials should be used.

The amount of added height

(1) Less than 1.5 mm If it is okay not to exceed 1.5 mm, surgery seemed possible with only septal cartilage + ear cartilage harvest. However, because the height would not be very great, there are limits to how much stretching can occur, so I explained that a dramatic improvement in the nostrils would be difficult.

(2) 1.5 mm or more If a height change greater than 1.5 mm was desired, I recommended using rib cartilage. If the height increases by 2 mm or more, as much as the nasal tip is pulled upward, you could also expect a more natural reduction in the nostrils.

Usually, many people think that using rib cartilage is a last resort chosen only after repeated revision surgeries for a failed nose surgery...

I do not think so.

One of the reasons revision surgery keeps happening in the first place is that from the very beginning of the surgical plan, people fail to recognize the limitations of the materials used in surgery and therefore do not use the appropriate material for the situation.

If the newly built support structure cannot withstand the pressure pushing on the top of the nose, the nose may gradually settle back down over time, differing from its original shape. Unexpectedly, many patients decide on revision surgery again and again because of this kind of cosmetic dissatisfaction.

Whether rib cartilage should be used,

whether it can be done with only comparatively less burdensome ear cartilage,

or whether only septal cartilage inside the nose is enough without ear cartilage or rib cartilage,

for these matters, I recommend carefully listening to the opinions of a plastic surgeon with extensive experience and a good aesthetic sense.

If it has already been decided to use rib cartilage, there is another decision to make.

You must decide between autologous rib cartilage harvested from your own body, near the rib area, or donated rib cartilage processed from a cadaver (a deceased person’s body).

I understand that many clinics use donated rib cartilage, but unless the patient strongly insists, I generally do not use donated rib cartilage.

It is already widely known that, compared with autologous rib cartilage, it has a higher absorption rate over time after transplantation, so it is less robust.

In addition, there have recently been reports of nose shape deformities caused by chronic inflammation.

Also, since the COVID era, most cadavers have been cremated, so obtaining proper donated rib cartilage has become incredibly difficult compared with the past.

Currently, COVID is no longer a problem, but for some reason the supply of donated rib cartilage still absolutely does not keep up with demand,

so it is still difficult to obtain, or companies are asking for excessively high prices. (It becomes too expensive for the patient.)

Before talking about the next main point, the explanation became long because rib cartilage needed to be discussed ^^;

Among the four points in bulbous nose surgery, the second thing to consider is the shape of the lower lateral cartilage, which extends from the nasal tip to both sides.

Source: MAYO FOUNDATION

The direction in which this cartilage extends is important, and so is the strength of the cartilage.

In fact, the nasal cartilage of most Koreans is very soft compared with that of Westerners.

It needs to serve as a firm support structure that can withstand the pressure of the skin, but there are limits to simply tying the cartilage together when it is this weak.

To strengthen it further, additional cartilage is needed. If rib cartilage can be harvested, a synthetic, beautifully shaped cartilage can be made and fused with the lower lateral cartilage, which allows both strengthening the cartilage and making it easier to control the direction in which the cartilage extends.

In any case, in this trainee’s case, she wanted not only bulbous nose surgery but also a naturally subtle result that would not look surgically done, while at the same time seeking a more dramatic change in the nasal tip and bridge height if possible,

and in the end she wanted to use autologous rib cartilage.

However, even if the patient wants it, we should not simply go ahead and do it without question.

Before finalizing the plan, I discussed the two concerns I had thoroughly with her and her parents.

The first concern was that the final audition was not far away and she would need to keep practicing dance, but there could be minor rib pain for a while.

The second was that a scar would remain on the thoracic area. Since she would likely wear revealing clothes while working as an entertainer, if a scar were visible, it could be bothersome.

However, when I harvest autologous rib cartilage, I usually make only a minimal incision of about 11 mm.

As far as I know, there are almost no doctors who can harvest cartilage through such a small incision.

It is technically difficult, and although it also takes more time, the reason I stubbornly insist on the difficult method is the scar the patient will carry for a lifetime.

Fortunately, the incision line has become smaller, from around 2.5 cm in the past to 1.1 cm, so in many cases the scar looks no more than a scratch, which seems to have greatly reduced the burden on patients.

The patient agreed that she could tolerate the pain, and after seeing several real examples of scars, she said it was fine as well.

Among the four factors considered in this patient’s bulbous nose surgery, the third point was 3. the degree of the fat layer beneath the thick skin.

Unfortunately, this part is difficult to identify precisely before surgery, so within a safe range during the operation, we decided to remove as much of the fat layer as possible.

We found during surgery that the fat layer was quite thick, so we could expect a noticeable effect after removal.

And the fourth and final point among the four considerations for correcting a bulbous nose was 4. nostril reduction surgery.

When people think of correcting a bulbous nose, they instinctively think of nostril reduction first,

and of course there are cases where that would be appropriate, but it is not the main solution.

In this case, even after raising the nasal tip, which was the first point, there might not be any extra room left to remove the nostril skin, so for this patient we decided to determine it at the very final stage of surgery, depending on the condition.

In the end, we also performed nostril reduction ^^;

This patient also wanted minor changes around the eyes, so we performed those together as well. (Eliminating the double crease and correcting the asymmetry of the double eyelids)

I’ll talk about this in more detail next time. ^^

Here are the three-month follow-up photos.

She had come to Korea because she was receiving training from a Korean entertainment agency before the final audition.

When I asked about the rib pain, she said she had slight thoracic pain until the second month, but now it does not hurt at all, so fortunately it does not interfere with dancing at all!

She said she had gained a little weight and was starting a diet again, so I prescribed diet medication for her too :)

After surgery, the height of the nasal tip increased by about 3.1 mm, and the height of the nasal bridge increased by an average of about 3.9 mm, though it varied by area.

At first glance, these numbers may not seem like a big change, but in reality, achieving this degree of change requires major work inside the nose.

The patient was very satisfied with the surgical results and expressed her gratitude many times.

I also hope that through such a positive change, the patient will gain confidence and achieve good results in future auditions.

If you are curious about improvement cases for short nose surgery, please click the post below.

Short Nose Surgery, These 2 Things Are a Must-Know for Revision Surgery .. : Naver Blog (naver.com)

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Roy Plastic Surgery complies with the Medical Service Act. The photos in this post were taken under the same conditions, and were captured with the patient’s prior consent. In addition, after plastic surgery and procedures, side effects such as bleeding, infection, and inflammation may occur depending on the individual, so caution is required.