Crooked Tip and Columella Corrected by Removing the Nasal Implant and Septal Extension Graft (SEG): Part 2
Cases in which the nasal tip and columella become crooked and nasal obstruction develops after rhinoplasty are surprisingly commonThere are 4 commonly cited causes.
01. The nasal implant was placed crooked02. The columella became crooked because the columellar strut was sutured incorrectly when it was fixed03. The septal extension graft was placed on one side only04. The cartilage graft placed on the tip sits off to one side
When the tip and columella are crooked after rhinoplasty, identifying the exact cause in this wayand making a surgical plan suited to the individual is the most important thing
The cartilage protruding inside the right side of the nose was judged to be a piece of the derotation graftthat had been placed to lengthen the tip.Nothing was visible inside the left side.
All of the implant and grafted cartilage were removed through an incision inside the nose alone (closed approach).
After surgery, the columella is straight and the nostrils are symmetric.
After surgery, the nasal bridge was brought back to the midline and straightened, and the symmetry of the tip was restored.The tip is well projected and looks natural.
Seen from below as well, nostril symmetry has improved and the crooked tip has returned to the midline.
Patients often worry that the nose will become short and blunt once the implant is removed, but that is not actually the case.After the removal surgery, the tip is more projected and longer. The dorsal line is natural, and the bridge has not become much lower.