Shanghai Liu ChaofengLead: Understand nasal deformity correction in one sentence
lip repairIs forupturned noseHump nose,saddle nose、deviated nose、aquiline nosePlastic surgery to restore the shape and function of the nose through osteotomy, cartilage reconstruction, soft tissue remodeling and other means for structural problems such as garlic nose. Unlike conventional rhinoplasty that "becomes taller and stiffer", deformity correction should be solved firststructural problemsLet's talk about aesthetic improvement-most of them need to build a stent with costal cartilage or nasal septum cartilage, and correct and plastic shaping can be completed in one operation.
1. What is a nasal deformity
Nasal deformity (Nasal Deformity)It refers to the morphological abnormality of the nasal bone, nasal cartilage, or soft tissue formed after development, trauma, or previous surgery. Common types include the upturned nose (exposed nostrils、nasal tip upward), hump nose (dorsal osseous bulge), saddle nose (collapsed middle bridge of the nose), crooked nose (oblique nasal axis), aquiline nose (dorsal convex nose +Ptosis of nose) with a garlic nose (Round, blunt and enlarged nose). Partial deformities not only affect appearance, but may also mergenasal septum deviationFunctional problems such as ventilation disorders.
To judge which category you belong to, you can compare three observation angles:
the front: Whether the nose axis is centered (crooked nose), whether the nostrils are excessively exposed (upturned nose), and whether the nose is wide (garlic nose).
the side: Whether there is a bulge on the back of the nose (hump nose/hooked nose), whether the middle section is collapsed (saddle nose), whether the tip of the nose is drooping (hooked nose).
functionally: Whether there is unilateral nasal congestion and open mouth breathing (suggesting a deviation of the nasal septum).
Readers who are not familiar with the basic concepts of rhinoplasty are advised to read the website first.Full strategy for nasal plastic surgeryOne article, come back and sit back.
2. Dismantling of 6 rhinoids one by one: Causes and Correction Plans
1. Facing the sky nose: exposed nostrils, tip of the nose rotates upwards
causes: Most of them are caused by congenital short columella and insufficient development of the distal end of the nasal septum, resulting in excessive rotation of the tip of the nose (the nasal lip is significantly greater than 105°); a few are caused by excessive upward rotation in previous rhinoplasty operations.
Correcting ideas: The core is to "extend" rather than "bolster"-throughnasal septum extension graft(Most taken from the nasal septum cartilage or costal cartilage) Extend the columella, rotate the tip of the nose downward, and adjust the nasal lip to the natural range of 90°-105°. The exposure of nostrils will improve accordingly.
material selection: Mild to moderate nasal septum cartilage + ear cartilage available; severeshort noseOr repair cases usually require sufficient support from the costal cartilage.
2. hump nose: bony protuberance of the dorsal nose
causes: Overdevelopment at the junction of nasal bone and nasal septum cartilage forms osteochondral protuberances, which is partly related to adolescent development or callus hyperplasia after nasal trauma.
Correcting ideas: Graded according to hump height-mild (<2mm) can be smoothed by simply filing (commonly known as "bone grinding"); moderate and severe needsTruncated hump + lateralosteotomy and advancement, close the amputated "open roof" and rebuild the smooth aesthetic line of the back of the nose. in recent yearsRetaining rhinoplastyPreservation Rhinoplasty can lower the dorsal nose as a whole without damaging the structure of the dorsal nose. It recovers faster and has a more natural shape, and is suitable for some moderate humps.
material selection: Most hump nasal corrections mainly focus on the adjustment of their own osteochondral and do not necessarily require implantation of a prosthesis; if it is also required to raise the mountain roots, they can be combined with a prosthesis or costal cartilage.
3. saddle nose: middle section of the bridge of the bridge collapses
causes: Congenital dysplasia, collapse of the nasal septum support after nasal trauma, excessive resection of the nasal septum surgery, or infection that destroys the cartilage scaffold, and a "saddle-like" depression in the middle of the nasal dorsum, often accompanied by an upturned tip of the nose.
Correcting ideas: Mild saddle nose can be implanted orcartilage transplantationElevate the dorsum of the nose; moderate to severe saddle nose belongs toStructural reconstructionCategory, it is necessary to build an "L-shaped" or segmented stent with costal cartilage, while restoring the height of the dorsal nose and tip support at the same time. Traumatic saddle nose is recommended for reoperation 6 months after injury and after the tissue is completely stable.
material selection: Costal cartilage is the first choice for moderate to severe saddle nose reconstruction; for mild cases, expanded/silicone prosthesis combined with ear cartilage pad on the tip of the nose can be used.
4. crooked nose: deviated nasal axis
causes: Divide intotraumatic(mallocated healing of nasal bone fractures) anddevelopmental(Deviation of nasal septum, traction of nasal cone, deviation of nasal septum) Two categories, about 70% of the deviated nose is complicated with deviation of nasal septum and ventilation problems.
Correcting ideas: Simply correcting the appearance can easily relapse. The standard practice is "Bone + cartilage + septum"Three-layer simultaneous correction-osteotomy to reduce the nose cone, straightening or partially removing the deviated nasal septum, and fixing the central axis with a spreader Graft if necessary. For those with ventilation disorders, functional correction and appearance correction can be completed at one time.
material selection: It is mainly composed of autologous nasal septum cartilage and costal cartilage. It is generally not recommended to simply "cover" the skew with a prosthesis.
5. Hook nose: raised back of nose + drooping tip
causes: hump-like dorsal nose bulge superimposed on nasal tip rotation (nasal lip angle is less than 90°), and the side surface is in the shape of an "olecranon". When smiling, the tip of the nose droops more obviously, which is easy to appear visually serious.
Correcting ideas: It belongs to the combination operation of "hump treatment + nasal tip supination"-cutting or filing the nasal dorsal protrusion, shortening the excessive distal end of the nasal septum, using the tip of the nose to support the implant supination and fixing the tip of the nose. Only by using both methods can you change the side contour.
material selection: The nasal tip stent is mainly reconstructed with autogenous cartilage; if there is slight unevenness after resection of the nasal dorsum, it can be modified with soft periosteum or fascia.
6. Garlic nose: round, blunt and plump nose
causes: The alar cartilage is wide, the fornix angle is too blunt, and the skin and soft tissue of the nose are thickened, which looks like "garlic"; the skin of Orientals is thicker, and the improvement of pure soft tissue garlic nose is relatively limited.
Correcting ideas: Cartilaginous problems passedSuturing and shaping of the nasal mucosa cartilage + partial cephalic resectionNarrow the nose; those with soft tissue hypertrophy need to appropriately remove the subcutaneous fibrous adipose tissue at the tip of the nose; most also need cartilage grafting and elevationPoint of expression of nasal tipMake the nose "small and warped" rather than simply shrinking. Often associated withNarrowing of the noseJointly carried out, see the in-app "Nose Alar Reduction/Nose Head Reduction" topic for details.
material selection: Ear cartilage and nasal septum cartilage can meet most nasal tip shaping needs.
3. Comparison table of correction options for type 6 nasal deformities
| Malformation type | core issues | main surgical methods | common materials | operation difficulty |
|---|---|---|---|---|
| upturned nose | The tip of the nose is rotated upwards and the nostrils are exposed | Nasal septum extension + columella extension | Septal cartilage/costal cartilage | middle and high |
| hump nose | bony eminence of dorsal nose | Hump resection/filing + osteotomy advancement | Mainly based on self-adjustment | in |
| saddle nose | Mid-section of the bridge of the nose collapsed | Reconstruction of nasal dorsal pad height/costal cartilage scaffold | Costal cartilage/prosthesis + ear cartilage | high |
| deviated nose | Nasal axis deviation ± ventilation disturbance | Osteotomy reduction + nasal septum correction | Septal cartilage/costal cartilage | high |
| aquiline nose | Protrusive nose + drooping tip of nose | Hump treatment + nasal tip upturn fixation | autologous cartilage | middle and high |
| snub noses | Round, blunt and enlarged nose | Alar cartilage reshaping + soft tissue thinning | Ear cartilage/nasal septum cartilage | in |
4. Cost and recovery: What is the difference between deformity correction and ordinary rhinoplasty
costs: Deformation correction involves more complex operations such as osteotomy and cartilage reconstruction, and the cost is generally higher than that of simple rhinoplasty; structural reconstruction such as crooked nose and saddle nose is usually in the middle and high sections of the rhinoplasty price range, which is related to the degree of deformity and whether to take rib cartilage and doctor's qualifications. A detailed breakdown of the price composition can be found in the stationHow much does nasal surgery cost?Topic.
recovery: The early bruising and swelling after surgery involving osteotomy (hump nose, crooked nose) are more obvious than that of ordinary rhinoplasty. Generally, the stitches are removed in about 7 days, the swelling is about 70% in 2 - 4 weeks, and the final shape is finalized in 6 - 12 months; For key points of nursing during the recovery period, please refer to the stationFull rhinoplasty recovery schedule。
5. Must read before surgery: Three decision-making principles
Structure first and aesthetics later: When nasal septum deviation and ventilation disorders are combined, functional correction should be completed simultaneously with appearance correction to avoid secondary surgery.
Autogenous cartilage is preferred for deformity correction: Stent reconstruction requires high support and anti-infection properties of materials, and costal cartilage/nasal septum cartilage is superior to simple prostheses.
Select doctors with experience in deformity correction and repair: The operational complexity and repair rate of deformity correction are higher than those of conventional rhinoplasty. The doctor's experience in structural rhinoplasty directly determines the upper limit of the effect.
Author of this article:Dr. Liu Chaofeng, the content is compiled and released by its Medical Beauty Strategies section. Please indicate the source for reprinting.
6. FAQ
Q1: How to correct the nose?
A: The core is to lengthen the columella and rotate the tip of the nose downwards-adjust the nasal lip to 90°-105° with a nasal septum extension graft to improve nostril exposure. The nasal septum cartilage + ear cartilage can be used for mild to moderate levels, and the rib cartilage support is usually needed for severe short noses.
Q2: Does hump nose have to be sharpened?
A: Not necessarily. Mild humps (within about 2mm) can be filed and leveled; moderate and severe humps need to be amputated and lateral osteotomy and pushed inward; in some cases, retention rhinoplasty can be used to lower the nasal back as a whole, so that it can be leveled without "grinding." The plan depends on the height of the hump and the width of the dorsal nose.
Q3：saddle nose correctionWhat materials should I use?
A: Autologous costal cartilage is the first choice for stent reconstruction for moderate and severe saddle nose, which has strong support and good anti-infection properties; for mild collapse, varsity or silicone prostheses can be combined with ear cartilage. A history of infection or traumatic saddle nose should be preferred.
Q4：crooked nose correctionWill it affect breathing?
A: On the contrary-about 70% of the crooked nose is complicated with deviation of the nasal septum. Standardized correction of crooked nose is combined with straightening of the nasal septum at the same time, and postoperative ventilation is improved in most patients. It is normal to have a transient nasal congestion due to swelling early after surgery.
Q5：Hook nose correctionIs it major surgery?
A: It is a moderately difficult structural rhinoplasty that requires simultaneous treatment of nasal dorsum protrusion and tip droop. It is usually performed using an open approach and general anesthesia. The operation takes about 2-3 hours. The safety is controllable under the premise of mature technology, but the requirements for doctor experience are high.
Q6: Will shrinking the garlic nose leave scars?
A: Open surgery leaves a transverse incision of about 3-4mm on the base of the columella. After recovery, it is mostly light and thin lines, and the front face is almost invisible; if the nasal ala is reduced, the incision is hidden in the nasal ala groove. People with scar constitution must inform their doctor for evaluation in advance.
Q7: How long can corrective surgery be performed for a traumatic crooked nose?
A: Closed reduction can be attempted within 2 weeks after nasal bone fracture; if the window period is missed, osteotomy correction is recommended 6 months after the injury and the bone and soft tissue are completely stable. The effect is more controllable.
7. Conclusion
The key to correcting nasal deformity is not "how high the cushion is" but "whether the structure is right." First distinguish what type of deformity you belong to and whether you have functional problems, and then consult a doctor with experience in structural rhinoplasty for CT and morphological evaluation. The most time and cost-saving path is to solve both the morphology and function in one operation.
Medical disclaimer: This article is popular science content and does not constitute medical advice. Any operation has risks, and the specific plan should be based on a face-to-face evaluation by a qualified doctor.
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