Revision Rhinoplasty: Q&A

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In What Ways Can my Previous Rhinoplasty Be Improved? (photo)

I had my first rhinoplasty 4 years ago. My nostrils are uneven front the frontal view and sit at different angles / have varying columella "show" which is visible from the profile (see picture 3 and 4). When I smile they become quite retracted (pic 2). I'm mostly concerned with the first third of my nose and would be curious of possibilities to give my nostrils a less retracted appearance all the while not appearing heavily operated upon or significantly reducing the size of my nose. Thank you!

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uneven 4 years post-op

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5 Doctor Answers | Asked by ellyl4

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Improving uneven nostrils and columellar show

Revision rhinoplasty can be used to treat your excess columellar show. There are also ways of treating the nostril asymmetry as well. My link below discusses an example of hanging columella and alar retraction treatment in someone who had prior rhinoplasty surgery.

Improving Previous Rhinoplasty

A picture of the base of your nose would be helpful but it appears that a reduction of the flare of one nostril will improve the symmetry. The hanging columella can be lifted to eliminate the appearance of retracted nostrils.

Richard W. Fleming, MD

10 reviews

Beverly Hills Facial Plastic Surgeon

www.bevhills.com

You may be a candidate for a Non-Surgical Rhinoplasty to improve the appearance of your nose after previous Rhinoplasty Surgery.

I read your concerns and reviewed your photos: Your nostril asymmetry and excessive nostril-show may be amenable to a non-surgical treatment. I could not be certain without examining you, but in many patients nostril lowering may be achieved with carefully performed silicone nasal injections. I prefer Silikon-1000, an off-label filler for permanent results. My practice philosophy is to reserve revision rhinoplasty as a last resort. Hope this is helpful for you. Dr. Joseph more

Eric M. Joseph, MD

204 reviews

West Orange Facial Plastic Surgeon

www.ericmjoseph.com

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In What Ways Can my Previous Rhinoplasty Be Improved?

We all have facial asymmetry which in your case is more obvious in the second picture. This is the main reason for the right ala being longer. Retraction of lower cartilages can also lead to retraction of the ala as well as columella show. These can be improved with revision rhinoplasty in order to restore the structural support to the tip cartilages, unilateral Alar Repositioning Technique to restore symmetry to the nasal base, correction of columella show and reducing the lower 1/3 of the... more

Revision rhinoplasty

I see what you see there is likely room for improvement i am going to answer your qeustions in a general sense i would need to examine you and speak to you to give the best advice so here it is 1)un even nostrils can be improved sometimes by fixing tip asymmeteries - the photos are not perfit but you might have one 2) uneven nostrils can be improved with asymmeteric alar base reductions 3) alar rim grafts can improve nostril shape and the relationship to the... more

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