My Right Nostril is Slightly Retracted and Bigger Than the Left Nostril. Do You Think Alarm Rim Graft Would Help? (photo)

My Right Nostril is Slightly Retracted and Bigger Than the Left Nostril. Do You Think Alarm Rim Graft Would Help?

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7 Doctor Answers | Asked by Calmlotus in Los Angeles, CA

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My Right Nostril is Slightly Retracted and Bigger Than the Left Nostril. Do You Think Alarm Rim Graft Would Help?

Yes, from the photos you appear to have right alar notching or retraction. IMHO, the best solution is a composite skin/cartilage graft placed through a rim incision to lower the right alar margin. This is an isolated procedure and does not require a Rhinoplasty.

Treating alar retractio with rim graft

Alar rim grafts are great ways to bring down a retracted alar margin. They are best for relatively small improvements. Lower lateral cartilage repositioning is another technique that can be used and is usually best for more significant retraction. Without additional views of your nose it is hard to say which method would be best. Either would likely give you some improvement overall.

Alar rim grafting

Without having more of a history and performing an exam, it is difficult to comment. One or two photos that are really not ideal make it difficult. Alar rim grafts can provide suport, and composit grafts internally can sometimes lower alar rims if they are retracted.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

You may be a candidate for a Non-Surgical Rhinoplasty to lower the height of your nostril after previous Rhinoplasty Surgery.

I read your concern and reviewed your photo. In my practice, I have found a non-surgical approach is best for nostril-lowering after previous Rhinoplasty Surgery. Specifically, I may use Silikon-1000, an off-label permanent injectable-filler, to add volume to a retracted nostril rim. In select cases, this may lead to nostril lowering and restoration of symmetry without the cost or inconvenience of a revision rhinoplasty. I've attached a link to my non-surgical rhinoplasty gallery... more

Eric M. Joseph, MD

199 reviews

West Orange Facial Plastic Surgeon

www.ericmjoseph.com

Tip rhinoplasty

When the outer nostril rim is retracted or elevated from its natural/normal position (4mm up from the outer surface of the columella on a side view) there are 3 possible options to correct it or lower the outer nostril rim. 1-graft a piece of cartilage and skin or muscosa (composite) inside the nose just above the outer nostril rim 2-free up the outer edge of the tip cartilage and then swing the involved tip cartilage downward 3-insert a piece of cartilage as a graft to increase the... more

My Right Nostril is Slightly Retracted and Bigger Than the Left Nostril. Do You Think Alarm Rim Graft Would Help? (photo)

Alar retraction is the result of over-resection of the alar cartilage with subsequent upward retraction. Rarely, this is found in patients who have had no rhinoplasty. Alar rim grafting that is placed more inferiorly into the dissected rim skin should correct this problem.

Retracted Nostril Rim

An alar rim graft would improve the undesirable nostril rim retraction. Examination is necessary to determine if a cartilage graft is necessary or a composite graft, which includes both cartilage and skin. It is difficult to determine with the 2 pictures submitted, but you may also have a slight hanging columella which would contribute to the "retracted nostril" look.