A Small, Blunt Nose with a Deviated Septum — A Case That Planned Functional Rhinoplasty Together
2024. 5. 17.
A case correcting a small, low, blunt nose — how the design and whether to do alar reduction were judged, and the process of evaluating septal deviation on CT together with actual nasal obstruction symptoms and nasal examination to plan functional surgery.
Key points
- A blunt, round nose often comes with an originally gentle image, so making it too pointed can actually be hard to adjust to — a design that stays naturally round yet sharp matters.
- Even when the alae look spread, alar reduction is not always done. When the spread alae are expected to follow along once the tip is raised, it can be omitted.
- Septal deviation on CT must be evaluated together with actual nasal obstruction symptoms and nasal cavity examination — the need for functional surgery is not decided by imaging alone.
When the nose is small and low with a blunt tip, we often hear the concern that the face looks somewhat flat and puffy, giving a dull impression. But when correcting this kind of nose, thinking only about "how sharp to make it" misses two things. One is harmony with the image the person originally had, and the other is a functional problem that may lie behind the exterior.
This article organizes a case where functional rhinoplasty was performed together for septal deviation found on CT while correcting a small, blunt nose.
01
Why isn't a blunt nose made unconditionally pointed?
Someone whose nose has been blunt and round often has an originally gentle, round impression. So making the nose too pointed relative to their image can be hard to adjust to in many cases.
In such cases, a design is needed where the tip stays naturally round while still giving a sharp impression. Finding the point where there is no sense of incongruity from the image change while the person's complex is reasonably resolved is very important in surgery.
The patient in this case also wanted to keep a natural, somewhat round feeling, and the surgery was planned with that in mind.
02
The alae looked spread — why wasn't alar reduction done?
This patient's nose was broad and spread, but viewed from the side the tip was sunken downward — a case where the alae looked wider because of that. When the alae are spread, alar reduction is sometimes done and sometimes not.
| Judgment | Basis in this case |
|---|---|
| Alar reduction omitted | The alar width that would remain after the tip change was anticipated, so a separate incision was planned to be skipped |
| Soft-tissue removal added | A bit more removal of tip soft tissue (flesh) was added to improve the puffy look |
In other words, alar reduction is not decided just because the alae look wide — first confirm where the cause of the wide-looking alae is (in this case, the sunken tip), then choose the necessary procedure.
03
How was functional rhinoplasty performed together?
Septal deviation was observed on the preoperative CT, and nasal obstruction symptoms were also taken in the history. Functional surgery was not decided by imaging alone — nasal examination and symptom severity were evaluated together to plan the following.
- Deviated septum correction — functional surgery performed together while straightening the bent septum
- Open rhinoplasty — proceeded with an open approach, with silicone insertion planned at about 3–4mm
- Tip design — the tip was raised to a naturally round yet sharp degree, as organized above
In the postoperative course, tip form and breathing symptoms are each checked. Correction cases of similar nose shapes can be seen in the before-and-after photos.
04
Summary — form, function, and image are viewed together
Correcting a small, blunt nose is not a matter of tip height alone. The desired degree of change and the need for alar surgery are distinguished, and if septal deviation exists on CT, actual symptoms and nasal examination are evaluated together. Form and function are each planned after hearing their goals, risks, and evaluation criteria explained.
If you are curious how much change is possible for your nose, it can be checked along with a simulation in a 1:1 video consultation.
Frequently asked questions
Answers to common questions patients ask before a consultation.
Does correcting a blunt nose dramatically change the impression?
If the alae are spread, must alar reduction always be done?
Can shape correction and functional rhinoplasty be done at once?
Responses to treatment and recovery progress vary by individual. Outcomes and side effects vary from person to person. Bleeding, infection, swelling and asymmetry may occur. Please consult our medical team before making a decision.