BEFORE & AFTER
Upturned, short and bulbous nose — before and after at 6 days: side and 45° views after lowering the tip with autologous rib cartilage
Rib-cartilage rhinoplasty · Upturned nose · Short nose · Bulbous nose · Low nose · Autologous rib cartilage · RIBFIT™ · Day 6
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.
These KOWON Plastic Surgery rhinoplasty before-and-after photos were taken 6 days after surgery. Unlike the photos taken right after surgery, they compare the side and 45° views with swelling present, so you can see how the upturned, short nose has changed in the way it looks in everyday life.
Hello, this is Dr. Kim Hyung-taek of KOWON Plastic Surgery.
These are photos, taken 6 days later, of the patient introduced earlier with photos taken right after surgery. The patient’s biggest concern was an up-nose — a tip turned up so that the nostrils showed — and they wanted the short-looking nose brought down “just a little”. They wanted the tip left round rather than pointed, and after consultation chose autologous rib cartilage as the material.
With upturned-nose surgery, it is actually harder to judge the result during the swelling period than right after surgery. Swelling can make the tip look briefly more upturned or blunter, so patients often worry at this stage; this patient’s day-6 photos are a good example to ease that worry, which is why I am sharing them.
Changes seen in the side view
Before surgery, the tip turned upward so that the nostrils were fully visible even in profile, and the nose was short, leaving a long philtrum between the tip and the upper lip. The bridge was low, so the profile from the forehead to the tip looked flat.
In the photo 6 days later, the tip has come forward and down, hiding the nostrils that showed from the side, and as the nose has lengthened, the philtrum looks shorter. This length was created by supporting the tip with autologous rib cartilage; rib cartilage is strong, which helps keep the tip from curling back up as the swelling subsides. This is why the tip position at day 6 is almost the same as right after surgery.
The bridge was raised with RIBFIT™ — the same rib cartilage, finely diced — so the dorsum looks smooth even with swelling. With a hard implant, the outline tends to show on the dorsum at this stage, whereas cartilage particles spread softly under the skin and blend in naturally as the swelling settles.
Changes seen in the 45° view
The 45° angle is the one patients with an upturned nose are most reluctant to be photographed from, because the nostrils show even more than from the front, along with a spread, bulbous tip.
Before surgery, in the 45° view, the nostrils open upward and the tip is widely spread. In the photo 6 days later, the tip has come down so the nostrils are barely visible, and the spread tip has been brought together with tip-cartilage suturing, narrowing its width. You can also see that the drooping alae the patient worried about have been tidied naturally, as the lowered tip now sits level with the alae.
The request not to make the tip pointed can be seen in the 45° photo. The very end of the tip was shaped to keep a rounded feel, so even after the swelling goes down it is expected to remain a softly rounded tip rather than a sharp one.
Swelling at day 6 and the changes ahead
A faint yellow bruise is visible under the eyes in the photo; this is a normal stage of recovery commonly seen around a week after surgery, and it usually fades within two weeks. When the tip has been lowered with rib cartilage and the bridge raised with RIBFIT™, it is normal at this stage for the tip to look a little fuller and the bridge slightly higher than they will in the end.
As the swelling subsides, the tip is expected to become smaller and more defined than it is now, and the bridge to come down slightly and settle closer to the face. Because a hanging-columella correction was done as well, the area below the nostrils should keep a clean line from the side rather than looking stretched, even with the longer nose.
[OP PLAN]
- Diagnosis: bulbous nose + low bridge + upturned nose (up-nose) + short nose, with drooping alae
- Patient’s requests: correct the upturned nose, lengthen the nose only slightly, keep the tip round (not pointed), improve the drooping alae
- Tip: tip extension with autologous rib cartilage – brought forward and down to gain length and correct the upturned tip
- Bulbous tip: tip-cartilage suturing + tip soft-tissue trimming (keeping a rounded tip)
- Columella: hanging-columella correction
- Bridge: RIBFIT™ (diced autologous rib cartilage)
- Approach: open rhinoplasty (open incision)
- Photos taken: 6 days after surgery (side and 45°)
See this patient’s photos taken immediately after surgery
Day 6 after surgery is a time when swelling and bruising are noticeable, but it is also a point at which you can see that the lowered tip position and the added length have already settled in.
KOWON Plastic Surgery starts from natural-looking change, but aims beyond a result that simply doesn’t show — for a “natural-glam” rhinoplasty that brings out the flow of the line and its details.
As the swelling subsides and the tissues stabilise, the tip becomes more defined and the bridge a little lower, settling into a softer, more natural shape overall. The mark on the chest where the rib cartilage was harvested fades over time and does not interfere with daily life. Rhinoplasty results can differ with each person’s skin thickness and cartilage, and the settled final result can be seen after a sufficient recovery period.