The nasal deformity, caused by prior surgery in another facial area, was corrected using autologous tissue—specifically costal and auricular cartilage—to create a straight, well-defined nasal contour.
Additionally, fat grafting and non-incisional lower eyelid surgery for tear trough (aegyo-sal) creation were performed, resulting in a more defined and balanced facial appearance.

Total Nasal Structural Refinement – Balancing the Face Through Projection
1 year postoperative

In this case, the key aesthetic maneuver was moving the nasal structure forward to achieve facial balance.
The patient presented with underprojection and midfacial flatness, contributing to a juvenile or compressed look in profile and oblique views.

We performed:

• Septal extension graft for anterior projection and tip support
• Dorsal augmentation and columellar refinement
• Alar base and glabellar (radix) contouring
• >All procedures completed using 100% autologous tissue – no implants

The result is not a “sharp” nose, but one that simply belongs—quietly lifting the central axis of the face and bringing harmony to the surrounding features.

All autologous tissue

Complex Revision Rhinoplasty – Full Autologous Reconstruction Toward “The Forgotten Nose”
(7 months postoperative)

Preoperatively, the patient presented with an unnaturally projected, pointed tip, excessive rotation (“upturned” nose), prominent supratip fullness, and dorsal axis deviation creating visible asymmetry.
In addition, the columellar base appeared sunken, exaggerating nostril exposure and drawing unwanted attention to the center of the face.

Our goal was to create a nose so natural it becomes “forgettable”—
not by erasing identity, but by allowing the nose to blend seamlessly into the overall facial harmony.

Surgical strategy (100% autologous tissue):

• Diced costal cartilage to create a smooth, continuous dorsal line from the glabella to the supratip
• Septocolumellar extension graft to realign and stabilize the nasal axis
• Auricular cartilage graft to refine the tip and redesign nostril show
• Nasal sill (alar base) reconstruction using a local flap and fascial graft to restore the natural position and continuity of the columellar base
• Every structural change was designed to “disappear” into the face

No implants. No overcorrection.
Only the patient’s own tissues, arranged with precision, anatomical respect, and restraint.

The result is a nose that does not announce itself, yet quietly defines the harmony of the face.
This is our philosophy of “The Forgotten Nose.”

[Alar Rim Reconstruction and Nasal Surgery]

The appearance of the nostrils should be considered from multiple perspectives.

The position of the nasal tip, the shape of the nostrils, the alar rims, and the alae all work together to determine how the nostrils look.

This photo shows the patient without makeup.

Surgical correction of a contracted nose to restore normal nasal contour.
Autologous fat grafting can be effective in addressing surface irregularities and contour deformities of the skin. The extent of achievable correction depends on the condition and integrity of the surrounding tissues.

• Fat Harvesting & Processing (SNIF, Microfat & Nanofat) – ¥286,000
• Tip Plasty – ¥429,000
• Septal Extension Graft – ¥643,500
• Alar Rim Plasty – ¥214,500
• Alar Base Augmentation – ¥357,500
• Dorsal Augmentation – ¥429,000
• Rib Cartilage Harvesting – ¥858,000
• Auricular Cartilage Harvesting (Unilateral) – ¥214,500
• Dermal-Fat Graft Harvesting – ¥286,000
• Revision Rhinoplasty High Complexity – ¥500,500

Doctor:
Takanori Yamawaki, MD

Risks:
Fat Harvesting & Processing : Swelling, Redness, Hematoma, Subcutaneous bleeding, Pain, Infection, Scar, Edema, Deformation, Sensory disturbance.
Nose : Swelling, Hematoma, Pain (general), Nausea, Does not turn out as simulated, Pneumothorax, Scar, Pain, Deformation, Infectious disease, Subcutaneous bleeding, Absorption (of injected substance), Scar (repeated), Different hardness from original, Redness, Infection, Edema, Sensory disturbance.