Real Story 9: Correcting a Deviated Nose and Heavy Eyes

* Patient Profile

# Female in her 20s

# Surgical History

1. Eyes: Incisional double eyelid surgery, lateral and epicanthoplasty

2. Nose: Two previous rhinoplasty procedures using septal cartilage and donated rib cartilage

# Current Concerns

1. Eyes

- Low eyebrows that seem to weigh down on the eyes

- Narrow space between the eyebrows and eyes, causing a bulging and heavy appearance

- Weak eye-opening strength and closed outer corners, resulting in a harsh impression

2. Nose

- The nasal bridge is too high and the tip is severely deviated.

* Consultation

1. Eyes

- The narrow space between the eyebrows and eyes creates a feeling of congestion. Simply re-fixing the double eyelid line will not improve this; in fact, it might make the area look even more swollen.

- By performing an endoscopic forehead lift to release the corrugator muscles and raise the eyebrows to an ideal height, we can simultaneously address the heavy feeling and the eyebrow position.

- The forehead and eyes cannot be considered separately. Harmony between these two areas is essential for an ideal eye shape!

2. Nose

- The main issues were a drooping columella and a nasal tip axis severely deviated to the left after two surgeries. We planned to create a straight line by correcting the deviated nose.

- The bridge was excessively high compared to the flat forehead, creating an ‘Avatar-like’ look. We planned to lower the bridge while adding volume to the forehead for a more feminine appearance.

- A long nasal tip can make one look older than their actual age, so we planned to create an appropriate tip shape and angle.

* Surgical Plan

1. FIX-UP Eye Correction

- Endoscopic Forehead Lift

- Incisional Ptosis Correction (Revision)

- Dual Canthoplasty/Lateral & Lower Canthoplasty (Revision)

2. Rhinoplasty

- Implant Replacement

- Autologous Rib Cartilage Tip Plasty (Correction of deviated nose and long nose/drooping columella)

3. Forehead Fat Grafting

* Post-operative Progress

1. What is the most noticeable change? Despite the clear in-out double eyelid line, the eyelids do not look puffy at all, right? A very refreshed line has been achieved.

2. By releasing the strong corrugator muscles through a forehead lift and performing fat grafting, a smooth and beautiful forehead is completed.

3. Autologous rib cartilage from the right 7th rib was used. Since it is harvested through a short incision of about 3cm, there is little need to worry about scarring. In cases of severe deviation like this, it is crucial to use autologous rib cartilage for a definitive correction.

4. Deviated nose surgery is highly difficult, but patient satisfaction is usually very high. This is because it straightens the central axis, resolving the crooked appearance from the front.

5. By correcting the drooping columella and creating an ideal tip shape and angle, we achieved a very satisfying result.

6. When the forehead lacks volume, the face can appear flatter and longer. Combining fat grafting helps achieve a much more balanced and pleasing outcome.

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

The VIBE that comes from extensive experience.

Dr. Yeong-moon Yoo, Representative Director of VIBE Plastic Surgery

VIBE Plastic Surgery complies with all medical laws. These before-and-after photos were taken under the same conditions with the patient’s consent. Complications such as bleeding, inflammation, infection, and asymmetry may occur depending on the individual, and caution is required.