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2026.01.31
How nasal septal curvature affects nasal septum extension｜What you need to know to prevent nasal tip tilt
As a plastic surgeon certified by the Japanese Society of Plastic and Reconstructive Surgery, I have been involved in many cases of trauma, reconstruction, and congenital diseases, and have cultivated precise techniques and a deep understanding of anatomy. He entered the field of cosmetic surgery out of a desire to bring the power of cosmetics to his patients, as a change in one's appearance can also make one's mind more positive. Her specialties include general treatment of the eye area, injections, and sagging skin. I provide treatments that focus on beauty with the medical stance of "sincerely addressing the ideals of the patient.
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Designing natural beauty with trust.
I am Masataka Fujihashi, a board-certified plastic surgeon.
Nasal septum extension is a foundation-plasty procedure that provides three-dimensional control of the direction, height, and stability of the nasal tip.
However, the most important but often overlooked aspect of this surgery is the condition of the nasal septal cartilage itself, which supports the extension.
If extension is performed with a distorted base, the tip of the nose will easily tilt, no matter how carefully designed, causing a left-right difference and retroversion.
That is why nasal septal extension and nasal septal curvature cannot be considered in isolation.
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Importance of a straight nasal septum
In nasal septum extension, the nasal septum cartilage acts as a “pillar” to support the tip of the nose.
Therefore, if this cartilage is straight, it can be extended straight as designed.
On the other hand, if a curved nasal septum is used as is, the extension cartilage will be pulled in the same direction, increasing the risk of a tilted nasal tip.
If it is mild, it can be compensated for with placement efforts,Pre-correction is essential for advanced curvatures.is.
Adapted from: "The Complete Book of Plastic Surgery Treatment Techniques VII, Cosmetic Medicine, 1st Edition" (Kenseido Publishing Co., Ltd. 2019), p.109 Figure 5, with some modifications.
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What is nasal septal curvature?
Nasal septal curvature is a condition in which the nasal septum (cartilage, ethmoid bone, and plough bone), which separates the left and right nasal cavities, is bent.
It is estimated that about 90% of Japanese people have some form of curvature, which is not uncommon.
However, as the curvature becomes stronger, it can cause nasal congestion, mouth breathing, decreased sense of smell, headaches, snoring, and other problems that interfere with daily life.
Corrective surgery for the sole purpose of symptom improvement is covered by insuranceHowever,If performed at the same time as cosmetic surgery, it is at your own expense.will be.
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The curvature of the nasal septum causes both cosmetic and functional problems.
A curved nasal septum can cause distortion of the nasal bridge (strabismus) and misalignment of the nasal tip.
In many cases, there is a combination of bony and cartilaginous strabismus, and the left-right difference will not improve unless both are corrected at the same time.
Further narrowing of the nasal cavity on one side may lead to enlargement of the inferior turbinate on the opposite side, resulting in bilateral nasal obstruction.
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Simultaneous approach of nasal septum extension and nasal septum curvature correction
CT is used to accurately assess the location and extent of the curvature, and the nasal septal cartilage is removed and re-fixed if necessary.
A shallow incision is made in the preserved cartilage to straighten it, and cartilage is transplanted for reinforcement, creating a structure that is less likely to recur.
The good quality cartilage obtained in this process is also important as an autologous material for lengthening and rhinoplasty.
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Expected Effects
In addition to functional benefits such as improved nasal breathing and reduction of chronic nasal congestion and snoring,Distortion of the nasal bridge and tip of the nose is corrected, and overall facial balance is improved.
Furthermore,Stabilizes the foundation of the nasal septum extension, greatly reducing the risk of left-right differences and retroversionI will do so.
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Complications and risks of nasal septum curvature correction
Infection, left-right difference, bending, retroversion, nasal septal perforation (hole opening), worsening of nasal obstruction, saddle nose, and postoperative bleeding may occur.
Because the nasal septum and mucosa are rich in blood flow, bleeding may occur for about a week after surgery, and in rare cases, hemostatic treatment may be necessary.
In addition, internal bleeding, swelling, pain, sensory disturbance, hematoma, and exposed threads may occur.
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■ Summary
Accurate evaluation of the condition of the nasal septum prior to extension is essential for a successful nasal septum extension.
Surgery with a missed curvature can lead to nasal tip tilt, left-right difference, and retroversion.
Combined use of curvature correction, if necessary, increases the stability of the structure and the naturalness of the result.
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【Profile】
Masataka Fujihashi, MD, Plastic Surgeon
Leveraging expertise as a board-certified plastic surgeon, I offer comprehensive facial cosmetic procedures including eyelid and nose surgery, facial liposuction, thread lifts, and hyaluronic acid injections. From incisional surgeries and revision procedures requiring delicate design to minimally invasive injections and lifts with minimal downtime, I strive to provide treatments tailored to each patient's ideal outcome.
We are dedicated to achieving natural results and minimizing downtime, pursuing medical care that leaves you feeling confident in your choice through sincere consultations.
Designing natural beauty with trust.
We cherish that sentiment and apply it to our daily practice.
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【Career】
March 2015: Graduated from the School of Medicine, Showa University
April 2015 Showa University Yokohama Northern Hospital Initial Clinical Training
April 2017 Showa University Hospital Department of Plastic Surgery
October 2017 Maebashi Red Cross Hospital Plastic Surgery / Cosmetic Surgery
April 2019 Nishio Municipal Hospital Plastic Surgery Department
April 2020 Showa University Fujigaoka Hospital Plastic Surgery Department
November 2020 Ota Nishinouchi Hospital Plastic Surgery / Cosmetic Surgery
July 2022 Tokyo Rosai Hospital Plastic Surgery / Cosmetic Surgery Department Head
July 2022: R.O.clinic (Part-time), Kusano Taro Clinic (Part-time)
April 2024 Deputy Director, Ginza TA Clinic
November 2025 BIANCA CLINIC
【Professional Affiliations and Qualifications】
Japanese Society of Plastic and Reconstructive Surgery Board-Certified Plastic Surgeon
Member of the Japanese Society of Aesthetic Plastic Surgery (JSAPS)
Member of the Japanese Society of Aesthetic Surgery (JSAS)
