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?

Doctor Answers (7)

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

+1

 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.


Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 12 reviews

Treating alar retractio with rim graft

+1

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.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 15 reviews

Tip rhinoplasty

+1

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 vertical height of the tip cartilage

Without a face to face examination it is impossible to know which option would be best for you or if some options would give you equivalent results.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

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

+1

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. 

Mohsen Tavoussi, MD, DO
Huntington Beach Facial Plastic Surgeon
4.5 out of 5 stars 9 reviews

Retracted Nostril Rim

+1

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.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 15 reviews

Alar rim grafting

+1

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
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

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

+1

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 here on RealSelf for your perusal. There are several examples of permanent non-surgical nostril lowering.

Hope this helps.

Dr. Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
5.0 out of 5 stars 278 reviews

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.