Rhinoplasty

 

630.<Rhinoplasty>

Rhinoplasty, commonly known as a nose job, is a surgical procedure aimed at enhancing the aesthetic and/or functional aspects of the nose. Typically, it involves augmentation of the nasal dorsum and refinement of the nasal tip.

For tip refinement, both open and closed approaches are available—each with its merits. Open rhinoplasty provides enhanced surgical visibility, while closed techniques offer minimized scarring.

Dorsal augmentation may utilize either alloplastic implants (such as silicone, Gore-Tex, Medpor, or custom 3D-printed forms) or autologous grafts. While alloplastic materials are convenient, they carry a potential risk of foreign body reaction, especially when the immune system is compromised. Therefore, autologous rib cartilage is often preferred for its biocompatibility and volume suitability. To address issues such as warping, rib cartilage can be processed into ultrafine particles, eliminating the drawbacks of both synthetic implants and raw cartilage.

Surgical strategies vary based on anatomical need: dorsal hump reduction for prominent bridges, cephalic trim for elongated tips, derotation wing grafts for short noses, and osteotomies or septoplasty for deviations. In cases of turbinate hypertrophy, submucosal resection may improve airway patency. Tip projection may be enhanced with structural grafting or ultrafine rib cartilage pocket insertion.

Healing of ultrafine cartilage grafts relies on plasma diffusion and typically stabilizes after 3 weeks—requiring careful postoperative care.

Although rhinoplasty can bring the nose closer to one’s desired image, it must be considered that nasal form evolved as an adaptation to ancestral environments. Alterations, if misaligned with climatic function (e.g., cold/dry vs. warm/humid climates), may pose long-term adaptation challenges. Thus, if rhinoplasty is truly desired, the use of autologous materials and minimally invasive techniques is recommended to minimize future complications.

[Rhinoplasty is the art of reshaping the terminal organ of respiration]
– 630mm growing pine tree-
#Rhinoplasty #NasalSurgery #NaturalNose #ClosedRhinoplasty #AutologousCartilage

Depressed Nose Correction

 

629. Depressed Nose Correction

Depressed nose correction is not merely about augmenting a low nasal bridge; it typically involves addressing both the sunken nasal tip and the surrounding bony structures of the nose. In many cases, both the nasal bones and cartilage are weak, and the septum is also commonly compromised. If the depression is due to trauma, the surgery becomes more complex, and when the nose has collapsed due to multiple previous rhinoplasties, reconstructive nasal surgery is often required.

Patients with congenitally depressed noses frequently present with maxillary hypoplasia, which is often associated with a mild form of Binder syndrome. In such mild cases, standard rhinoplasty combined with paranasal augmentation can elevate not only the nasal bridge and tip but also the surrounding midface area. If the nasal tip cartilage is weak, it can be reinforced using costal cartilage, making the tip more structurally sound. For more precise augmentation around the nasal base or correction of the nasolabial angle, particulate costal cartilage grafting can be used to fill the micro-deficiencies in the maxillary bone. Artificial implants, on the other hand, carry a higher risk of infection and often fail to fit snugly against the maxillary bone, leading to potential implant migration or inflammation. Thus, autologous particulate cartilage grafting is preferred.

In trauma-induced nasal depression, the status of the nasal septum must be thoroughly evaluated, and septal reconstruction may be necessary. For non-primary surgeries, it is often better to open the columella to allow direct visualization and control over the septum.

In cases where multiple rhinoplasties have resulted in a severely weakened septum and tip cartilage, making nasal support difficult, a cantilever rhinoplasty is recommended. The term "cantilever" comes from architecture, referring to a structure fixed at one end and free at the other. In rhinoplasty, this concept is applied by inserting a single, long, firm cartilage strut, shaped from costal cartilage, from the nasal bridge to the columella to provide support. A double cantilever graft, using two cartilage struts symmetrically placed on either side of the midline, is used when there is little to no septum left, creating balanced support. In some cases, this method is combined with spreader grafts to widen the nasal bridge, forming a hybrid support system. The L-shaped cantilever graft, a structural cartilage piece shaped like an L, is increasingly used to reconstruct short, collapsed, or severely sunken noses.

Septal reconstruction is generally performed with autologous costal cartilage sliced thinly, mimicking the septum’s natural form. When the septum is entirely absent, structural grafts are arranged in an L-shape to simulate a septal framework, similar to building a steel frame in architecture. This is often done in conjunction with cantilever rhinoplasty.

In summary, depressed nose correction involves rebuilding the framework of the nasal bridge and tip using cartilage grafts, while simultaneously reconstructing the central support with septal grafts to restore the collapsed nasal structure.

[Depressed nose correction is a procedure that reconstructs the sunken parts of the nose by augmenting or rebuilding them with cartilage.]

— 629mm Growing Pine Tree 🌲

Hump Nose Correction: Preserving Structure, Enhancing Beauty

 

628. <Hump Nose Correction: Preserving Structure, Enhancing Beauty>

Hump nose correction (dorsal hump rhinoplasty) refines the nasal profile by addressing an overprojected bony-cartilaginous hump. While traditional structural rhinoplasty involves osteotomy and implant use, it may disrupt the nose’s natural contour and raise risks of infection—especially when synthetic materials are involved.

To reduce such complications, we often prefer autologous tissue like diced costal cartilage to reconstruct and elevate the nasal dorsum safely and naturally. In recent years, preservation rhinoplasty has emerged as an elegant solution. Rather than removing the hump, we reposition the entire nasal bridge using let-down or push-down techniques, preserving the native anatomy and minimizing trauma.

This approach is rooted not only in surgical advancement but also in evolutionary insight—the dorsal hump evolved to condition cold air. Altering it requires thoughtful consideration of both airflow and aesthetics.

Hump nose is often accompanied by other issues like nasal deviation or a droopy tip. A comprehensive facial analysis, including septal deviation, facial asymmetry, and even bite alignment, is essential. In some cases, orthognathic surgery may also play a role.

Cosmetic correction is optional—but when desired, selecting between structural and preservation techniques should be based on anatomy, healing profile, and personal goals.

“Hump nose correction is the restoration of balance—not just the removal of a feature.”
— 628mm Growing Pine tree-

#PreservationRhinoplasty #HumpNoseCorrection #DorsalHump #NaturalNose #FacialBalance #RhinoplastyExpert #ModernRhinoplasty #NoseSurgery #AestheticHarmony #EFILPlasticSurgery

Deviated Nose Correction

 

627. <Deviated Nose Correction>

A deviated nose correction is a type of rhinoplasty that corrects both the external shape and internal structure of a nose that has deviated from the central axis. Both cosmetic and functional corrections are usually performed together.

A deviated nose can result from trauma during childhood that leads to deformation, but it may also occur due to habitual behaviors developed during the growth process. For example, if one consistently sleeps while lying on one side, the nose may be gradually pushed in that direction. Over time, this causes one side of the nose to have a gentle slope and the other side a steep slope.

Similarly, a habitual one-sided smile can cause the nose to deviate. This is because the asymmetric contraction of muscles around the nose can pull the tip of the nasal cartilage to one side, resulting in a crooked nose. The levator labii superioris alaeque nasi muscle originates from the maxilla near the nasal root and inserts into the nasal ala and upper lip, lifting both when contracted. The depressor septi nasi muscle arises near the incisive fossa of the maxilla and inserts into the septal cartilage and tip cartilage, pulling the nasal tip downward during contraction. When one habitually raises the right side of their lip in a crooked smile, the nasal ala is pulled to the right, and the depressor septi nasi on the same side also pulls downward. This creates a C-shaped deviation. If the pull is to the opposite side, an S-shaped deviation can occur. The shape of the deviation depends on how severely the septal cartilage is bent and the asymmetric contraction of the depressor septi nasi muscle on each side.

Additionally, the levator labii superioris muscle pulls the upper lip upward, and during smiling, the area beside the nose is lifted. This interferes with the movement of the nasal ala. The zygomaticus muscles, when overused in a crooked smile, can develop asymmetrically. This causes differences in the flaring of the nostrils, leading to visible asymmetry. Especially when the nasal septum is weak, a long history of crooked smiling makes deviation more likely.

Such a crooked smile often stems from an uncomfortable or distorted emotional state. A twisted mind leads to asymmetrical muscle use in the face, which eventually results in a crooked nose.

So how should a deviated nose be corrected? Since asymmetrical muscle habits can lead to asymmetrical bone structure, re-correction of the nasal bones is necessary. This is done by performing lateral osteotomy on the sides of the nasal bones, and if needed, medial osteotomy may also be added. If there was a previous nasal fracture, osteotomy can follow the old fracture lines.

Correcting only the outer nose while neglecting the inner structure, such as the septum, is insufficient. A simultaneous correction of the nasal septum allows for both functional and cosmetic improvement. Therefore, it is common to perform septoplasty for a deviated septum (see 623mm) in conjunction with the procedure, which often includes trimming the lower portion. It is important to assess not just the external shape but also the airflow through the nostrils before surgery to determine whether nasal obstruction is present on one side.

In cases of asymmetry due to depressor septi nasi or a sharp nasolabial angle, dissection near the anterior nasal spine is performed. Cartilage grafts using diced cartilage can be placed to reduce the influence of the depressor septi nasi, helping to prevent recurrence and drooping of the nasal tip.

Also, with prolonged one-sided crooked smiling, the area around the nose tends to become sunken on the active side. This occurs because muscles like the levator labii superioris alaeque nasi contract to lift the nasal ala and upper lip inward, while the zygomaticus pulls the corner of the mouth outward and upward. This muscle hypertrophy compresses the surrounding bone and drains subcutaneous fat energy from the area, resulting in volume loss and hollowing.

This imbalance causes the nasal tip to shift toward the dominant side of the smile. In such cases, a structural augmentation around the nose is required. Using diced costal cartilage grafts, the sunken area on the smiling side should be more heavily grafted, while the opposite side receives less grafting. This rebalances the nasal tip and recenters both the nasal bridge and tip.

In this way, diced costal cartilage can be inserted over the deviated nasal bridge following lateral osteotomy, effectively masking the crooked contour. Simultaneous grafting around the nose provides a more fundamental correction of the deviated nose.

[Deviated nose correction is a procedure to straighten a nose distorted by a distorted mind.]

– 627mm Growing Pine Tree –

Arrow Nose Correction

 626. <Arrow Nose Correction>

An arrow nose, where the tip droops and nostrils are hidden, creates the impression of a long, downward-pointing nose. Genetically, this shape evolved in colder climates—where longer nasal passages helped warm and humidify air before it reached the lungs. Over time, this led to more developed nasal bones and cartilage, forming a prominent, arrow-like silhouette.

Functionally, overuse of the depressor septi nasi muscle—especially during smiling or lip-puckering—can further accentuate the droop, making the tip fall over time.

Surgical correction focuses on refining and lifting. Instead of altering the nasal bone, we perform a cephalic trim—removing a portion of the upper alar cartilage to shorten the tip. The medial and lateral crura are sutured to enhance tip support, and if needed, autologous cartilage grafts (from the ear or rib) are used to project and rotate the tip.

Using a closed-open hybrid approach, we avoid external scarring and preserve tip circulation. A 1.5cm chest incision allows safe rib cartilage harvesting, which we sculpt into tip grafts and fine particles for dorsal refinement.

To prevent recurrence, we may dissect the depressor septi nasi origin and reinforce the nasolabial angle using rib cartilage micrografts, restoring facial harmony and expression.

This is not just aesthetic—it’s anatomical elegance. Done correctly, arrow nose correction restores balance while preserving the nose’s natural beauty and function.

“Arrow nose surgery is the art of lightening the heaviness of evolution—gracefully.”
—626mm growing pine tree-
#ArrowNose #CephalicTrim #ClosedRhinoplasty #AutologousGraft #EFILClinic #StructuralRhinoplasty

Rhinoplasty for the Upturned Nose

 

625. <Rhinoplasty for the Upturned Nose*

An upturned nose—short, with excessive nostril show—is more than a cosmetic concern; it reflects an underdevelopment of the nasal bones and cartilaginous structures. Genetically, it’s often seen in those with ancestry from warmer climates, where a shorter nasal passage was advantageous for rapid airflow and less need to humidify or warm the air. Evolution shaped the form. But in today’s world, harmony in facial proportions often calls for correction.

True upturned nose correction is not a simple lift or implant. It’s a thoughtful reconstruction. Because the nasal bones are difficult to lengthen, we instead focus on the scroll area between the upper and lower lateral cartilages. This area is carefully released, and autologous cartilage—often harvested delicately from the rib through a 1.5cm incision—is inserted to elongate the nasal structure with lasting stability.

To preserve function and minimize visible scarring, we use a closed-open hybrid technique, avoiding full columellar incisions. This approach maintains blood supply to the tip, reduces downtime, and enhances aesthetic finesse.
When asymmetry exists between the nostrils, we employ derotation wing grafts—a precise method of adjusting each side independently to restore balance while correcting the upturned shape.

If alar flaring accompanies the upturned nose, we discreetly perform alar base reduction, placing stair-step incisions just above the alar crease to naturally conceal scars and prevent unnatural tightness or "droplet" shapes.

Above all, surgical correction should never compromise function. Autologous tissue ensures the nose remains soft, natural, and integrated with the body. Unlike artificial implants, it reduces the risk of capsular contracture or further retraction. Done thoughtfully, this surgery is not just cosmetic—it restores balance, breath, and confidence.

Accepting one’s natural shape is always beautiful. But when change is desired, we believe in safe, anatomical, and elegant solutions tailored to each unique face.

[Upturned nose correction is a graceful elongation of nose by putting interpositonal graft]

— 625mm growing pine tree-

Rhinoplasty for Chronic Rhinitis: A Surgical Perspective

 

624. <Rhinoplasty for Chronic Rhinitis: A Surgical Perspective>

Rhinitis surgery addresses nasal congestion caused by chronic inflammation of the nasal mucosa, leading to symptoms such as sneezing, excessive mucus, and itching. The inferior turbinate plays a crucial role in filtering and humidifying the air before it reaches the lungs. However, prolonged exposure to environmental pollutants and allergens can lead to excessive mucosal swelling, disrupting normal airflow.

Modern surgical techniques aim to alleviate these symptoms. Radiofrequency ablation and HIFU reduce hypertrophic tissue, while turbinate reduction preserves mucosal function. However, radical procedures like turbinectomy may lead to long-term dryness and compromised airway filtration.

Ultimately, surgery does not cure rhinitis but manages symptoms. True healing begins with clean air, a pure diet, deep sleep, and regular movement—nurturing nasal health from within.

[Rhinitis surgery alters nasal anatomy but does not restore natural mucosal balance.]

-624mm Growing Pine tree-

#RhinitisSurgery #BreatheBetter #NasalHealth #TurbinateReduction #SinusRelief #AllergyCare #ENTsurgery #FunctionalRhinoplasty #HealthyBreathing #EFILPlasticSurgery

Septoplasty: Restoring Nasal Balance and Function

 

623. <Septoplasty: Restoring Nasal Balance and Function>

Septoplasty is a surgical procedure designed to correct a deviated nasal septum, ensuring optimal airflow and nasal function. The nasal septum, composed of cartilage and bone, divides the nasal cavity into two passages, facilitating efficient respiration, olfaction, and mucosal clearance.

One common cause of septal deviation is chronic overuse of the depressor septi nasi muscle. Habitual asymmetric facial expressions—such as smirking or pursing the lips—can lead to an imbalance in muscle tension, gradually pulling the septal cartilage off-center. Over time, this deviation can become structural, compromising nasal airflow and leading to conditions such as nasal obstruction, rhinitis, and even chronic sinusitis. Traumatic injury can also result in septal misalignment, further impairing nasal function.

Septoplasty involves precise surgical correction: an incision is made to expose the deviated cartilage and bone, which are then reshaped or selectively removed while preserving the essential L-strut framework. Careful technique minimizes the risk of septal perforation and ensures structural integrity. In cases of bony deviation, specialized instruments are used to refine the nasal framework, enhancing both form and function.

Beyond restoring nasal symmetry, harvested septal cartilage can be repurposed for nasal tip refinement in aesthetic rhinoplasty. By addressing septal deviation, septoplasty not only enhances breathing but also contributes to overall nasal health, preventing chronic inflammatory conditions and optimizing respiratory function.

[Septoplasty is a functional procedure that restores the natural balance of airflow, promoting effortless breathing and long-term nasal health.]

#Septoplasty #NasalHealth #BreatheBetter #Rhinoplasty #NasalSurgery #FunctionalRhinoplasty #SinusHealth #ENTsurgery #AestheticMedicine #EFILlPlasticSurgery

Nasal Tip Plasty

 622. <Nasal Tip Plasty>

Nasal tip plasty is a type of rhinoplasty performed when the shape of the nasal tip is unsatisfactory—such as when it appears bulbous, droopy, upturned, crooked, too high, or too low. The goal is to create a more natural or refined nasal tip.

There are two main approaches: closed and open. While synthetic implants are sometimes still used for the nasal bridge, autologous tissue (like ear cartilage, septal cartilage, or rib cartilage) is increasingly preferred for the nasal tip to avoid complications like implant extrusion or infection.

Closed nasal tip plasty includes:

1. A minimal incision to insert an implant, sometimes with added dermal grafts or ear cartilage.

2. The "closed-open" method (closed exposure rhinoplasty), where the entire tip cartilage is exposed through internal incisions without cutting the columella.

Open rhinoplasty involves incising the columella, providing full visibility of the nasal tip structures. This is useful in complex cases, but should be avoided unless necessary due to the risks of visible scarring and disruption to the columellar artery, which can reduce blood supply and increase the risk of tip necrosis—especially if lateral nasal arteries are also damaged during surgery.

When the nasal tip is short, it may be corrected by inserting cartilage between the lower and upper lateral cartilages to lower the nostrils. If the tip is long, cephalic trimming (removing upper part of the lower lateral cartilage) can lift it. Bulbous tips may require fat removal, while overly pointy tips can be softened with micro-fragmented cartilage grafts.

To support or project the tip, autologous cartilage—such as ear, septal, or rib cartilage—is used. While septal cartilage may be insufficient in many Asian patients due to low nasal bridges, overharvesting ear cartilage can deform the ear. Rib cartilage, while initially firm, softens over time due to metaplasia, making it a reliable option for long-term shaping.

For large noses, tip cartilage is reduced; for small noses, grafts are added. Rib cartilage can serve both tip and bridge reconstruction using grafts and particles, making it an all-in-one solution.

[Nasal tip plasty aims to refine or reshape the nasal tip using grafts or sculpting for a natural or elegant appearance.]

– 622mm Growth Pine Tree –

#NasalTipPlasty
#Rhinoplasty
#TipRhinoplasty
#ClosedRhinoplasty
#OpenRhinoplasty
#CartilageGraft
#NaturalNoseJob
#FacialBalance
#RhinoplastyJourney
#BeforeAndAfter
#PlasticSurgeryInfo
#KoreanRhinoplasty
#RhinoplastyExpert
#NoseTipSurgery
#CosmeticSurgeryEducation

Dorsal Rhinoplasty: The Key to a Natural, Long-Lasting Nose

 

621. <Dorsal Rhinoplasty: The Key to a Natural, Long-Lasting Nose>

Dorsal rhinoplasty enhances the nasal bridge, improving both aesthetics and function. This procedure includes dorsal reduction, lateral osteotomy for deviation correction, and augmentation to achieve ideal height and contour.

Why Avoid Synthetic Implants?

Silicone, Gore-Tex, and Medpor implants are widely used but often lead to complications like infection, capsular contracture, and long-term deformities due to lymphatic contamination. Processed food intake and poor sleep disrupt lymphatic drainage, increasing biofilm formation around implants, leading to delayed rejection and revision surgery.

The Best Solution: Autologous Cartilage

Using the patient’s own tissue eliminates foreign body reactions, integrates naturally with nasal structures, and ensures long-term safety. Costal cartilage, especially when diced and layered, prevents warping and maintains a smooth, natural contour. The future of rhinoplasty lies in biocompatibility—choose wisely for results that last a lifetime.

—621mm Growing Pine tree-

#NoseBridgeSurgery #Rhinoplasty #NoseAugmentation #NaturalNose #NoseRevision #NoseContour #NoseJobBeforeAfter #BridgeEnhancement #PerfectNose #NoseFiller
#efilplasticsurgery

Eyelid Surgery: Aesthetic & Structural Enhancement

 

620. <Eyelid Surgery: Aesthetic & Structural Enhancement >

Eyelid surgery, or oculoplastic surgery, includes eyelid contouring, orbital bone reshaping, and brow lifting. This field blends soft tissue & skeletal adjustments to create balance and proportion in the eye area. 👁️

🔹 Blepharoplasty (Eyelid Surgery) ✅ Upper Blepharoplasty: Enhances the eyelid crease, correcting ptosis if needed. ✅ Lower Blepharoplasty: Reduces under-eye bags & sagging. ✅ Canthoplasty: Modifies inner & outer eye corners for refined shaping.

🔹 Brow Aesthetic Procedures ✅ Brow Lift: Elevates brows for a youthful look. ✅ Eyebrow Transplant & Tattooing: Defines & fills brows naturally.

🔹 Brow Bone Contouring ✅ Reduction: Softens prominent brow ridges. ✅ Augmentation: Creates a more structured, defined look. ✅ Advancement: Adjusts protrusion for facial harmony.

🔹 Orbital Volume Adjustment ✅ Protruding Eye Surgery: Reduces bulging eyes. ✅ Sunken Eye Correction: Restores lost volume for a rejuvenated look.

Strategic Approach to Eye Surgery

Eyelid surgery isn’t just about soft tissue—it involves bone structure, asymmetry analysis & customized techniques. 📐

✔️ If both skeletal & soft tissue concerns exist, correcting the bony framework first ensures better results. ✔️ 3D analysis (front, side & oblique views) helps diagnose protrusion, asymmetry & fat redistribution effects. ✔️ Lower eyelid considerations: Excess orbital fat removal can subtly shift eye position—proper assessment prevents complications. ✔️ Facial asymmetry matters: Significant eye height differences require precise surgical adjustments.

Why Multi-Dimensional Eye Surgery Matters

Eyelid surgery is more than 2D skin adjustments—it considers bone structure, fat distribution & vascular factors for natural, long-lasting results. Since blood flow & tissue properties vary per person, both surgeons & patients must carefully assess pre-op factors. 🏥

👁️ Vision clarity matters more than aesthetics alone.

[Eyelid surgery is not just decoration; it’s the art of balancing structure & function]

-620mm Growing Pine tree-

#EyelidSurgery #Blepharoplasty #PtosisCorrection #EyeAesthetics #Canthoplasty #NaturalDoubleEyelids