Whenever I smile, it makes my nose look rather strange and this is really starting to bother me. The left set of pics are when my face is just still, the right set of pics is when I'm smiling.
Asymmetric Nostrils? What Procedure Can I Get to Fix This? Estimated Cost of Procedure? (photo)
Doctor Answers 5
You have a slight asymmetry of your nostrils, but the cause is unclear and would require an in person exam. It may be correctable with a simple maneuver involving your nasal septum.
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Asymmetric Nostrils--should I fix them, and if so how?
Asymmetric nostrils in a patient who hasn't had surgery are quite common. To understand the reason for the asymmetry, one must understand the anatomy. I compare the lower cartilages of the to the paired horns on a big-horn sheep. The top of the rams horns make up the tip, and the sides make up the support structure for the ala. These form the main structure of the ala (or nostril), along with the inherent stiffness of the muscular and fatty tissues of the lateral (side) of the nostril itself. In addition, the septum contributes to nostril symmetry--if it bulges to one side or the other, it will push the so-called 'medial crural footplate', or middle part of the ram's horns, to one side or the other.
I generally advise patients that mildly asymmetric nostrils are not uncommon. Furthermore, widening of the nostrils with smiling is quite common as well. A personal consult with a facial plastic surgeon could help you determine if your relatively mild asymmetry is worth trying to treat.
Hope this helps.
Asymmetric Nostrils? Will Rhinoplasty Fix This? (photo)
The photo shows divergent medial crural foot plates, and, like many, your alae elevate with your cheeks when you smile. My solution would be alar base narrowing and to trim the caudal septum during rhinoplasty.
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Asymmetric Nostrils? What Procedure Can I Get to Fix This? Estimated Cost of Procedure?
I would not recommend correction for this degree of asymmetry, particularly since the asymmetry is less prominent at rest.
Kenneth Hughes, MD
Los Angeles, CA
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.