Conference: 21st Meeting of the Korean Academy of Aesthetic Plastic Surgery (Shilla Hotel)
Date: March 2003

Presenter: Dr. Myung Ju Lee MD. PhD

Background

The nose serves both an aesthetic role—shaping the face—and a physiological role, facilitating respiration by allowing air to enter and exit the body. Historically, rhinoplasty has mainly focused on external appearance, often neglecting or leaving any functional nasal obstruction issues unaddressed. In fact, nasal function is intimately related to nasal structure, meaning that correcting underlying skeletal or cartilaginous deformities not only improves the nose’s appearance but can also significantly enhance its breathing function. An ideal rhinoplasty should therefore correct both cosmetic and functional problems by restoring normal anatomy.

Methods and Materials

Nasal function involves four key anatomical components:

1. External Nasal Valve
2. Internal Nasal Valve
3. Septum
4. Turbinates

When congenital deformities, trauma, or repeated surgeries compromise one or more of these structures, targeted interventions are needed to restore function and shape:

• External Valve Collapse: Lateral crural strut graft or batten graft
• Internal Valve Collapse: Spreader graft
• Septal Deviation: Septoplasty
• Hypertrophic Turbinates: Turbinectomy (selective resection in severe cases; more conservative widening if less severe)

Results

By correcting anatomical deficiencies at their source, surgeons could improve both the nose’s external appearance and airflow. Severely hypertrophic turbinates were resected only when necessary; milder cases were managed by widening the nasal passage. In most cases of significant deformity, the issues stemmed from prior surgeries or trauma. Even patients with a prominent dorsal hump (e.g., a hump nose) frequently presented with an accompanying septal deviation that distorted both the nose’s appearance and internal breathing space. A combination of osteotomy and spreader graft placement effectively remedied these problems.

This comprehensive approach underscores the importance of addressing both form and function in rhinoplasty, ensuring that patients benefit from improved aesthetics as well as enhanced respiratory function.