Rhinoplasty for a Low Bridge and Drooping Tip

* Basic Information

• Female in her 20s
• Previous procedures: Hiko threads and fillers (twice)
• Low nasal bridge and drooping nose tip
• Uneven bridge line due to a slight hump

* Consultation

1. Despite having two rounds of Hiko and filler treatments, she was concerned that her bridge looked wide and the line remained uneven due to her dorsal hump.
2. As many are aware, Hiko thread lifts have limitations and cannot effectively create a sharp, elevated nose tip.
3. The patient’s nose was naturally low and the septal cartilage was too soft, making it insufficient for surgery using only autologous cartilage. Therefore, we planned the surgery using donated rib cartilage.
4. She desired a ‘straight-semi-curved’ (Jik-ban) tip that extends clearly without exposing the nostrils excessively.

* Surgical Plan

• Dissolving existing fillers
• Removal of foreign substances (Hiko thread remnants and capsules)
• Bridge rhinoplasty (hump reduction, silicone implant)
• Tip rhinoplasty (Donated rib cartilage: Septal extension graft + Septal cartilage: Onlay graft)

* Post-operative Progress

1. Following the procedure, a natural yet sharp straight-semi-curved tip was achieved without excessive nostril exposure, exactly as requested.
2. The bridge became sleek and elevated, drawing focus to the center of the face. This added dimension to her previously flat features, creating a slimming effect on the overall face, which the patient found very satisfying.

* Key Points

1. There are varying opinions among both patients and surgeons regarding the use of donated rib cartilage. While I do not recommend it unconditionally, I believe it is a viable option when truly necessary.
2. The primary concerns with donated rib cartilage are inflammation and tip drooping. Since it is a foreign material, the risk of inflammation may be slightly higher compared to using only autologous cartilage. Additionally, depending on the absorption rate, the tip may unexpectedly droop or deviate.
3. However, I believe these issues mostly occur when the tip is raised excessively beyond what the individual can support, or when influenced by factors like smoking. If a proper surgical plan is established and negative factors like smoking are avoided, donated rib cartilage is a sufficiently good and sometimes necessary material.
4. I advise against Hiko thread procedures if possible. Hiko uses threads to lift the tip, but it is virtually impossible to maintain that lift long-term. Furthermore, these threads become significant obstacles during future rhinoplasty surgery.

Consultations and surgeries should always be performed by a board-certified plastic surgeon!

Wishing you health and beauty :)

Right Thoughts, Right Plastic Surgery – Yoo Young-moon

Note: Complications such as bleeding, inflammation, infection, and asymmetry may occur depending on the individual, and caution is required.