Hello, I had an initial rhinoplasty disaster 14 months ago where unknowingly and without my consent my alar base and nostril size was doubled. I merely believed to be in for a minor cosmetic procedure regarding deviated septum and many spreader grafts as well as a columellar strut graft was added to my septum. My nose is now too big for my face and too long and droopy. I can hardly lift my lip and it looks bulbous and very bad when I attempt smile or speech. I also have thick skin. Please help.
Can nostril size be decreased and tip sutured smaller in revision for thick skin patient? (photo)
Doctor Answers (4)
Nostrils that may appear widended after rhinoplasty may not be wider, but only appear that way from weakend walls
When the tip of the nose is made smaller by removing some of the nasal tip cartilage, that cartilage also gets weaker and the nostrils may narrow or slightly collapse. This narrowing makes it appear like the nostrils have widened, when actually they are the same width but there is a new, unnatural shadow that runs from the crease above the nostril to the edge of the nostril. This is most evident on front view and the view from below. Treatment is actually by adding grafts to strengthen the nostril wall and smooth out the shadow that makes the nostrils look almost "stuck-on."
Nostril size ( revision nose surgery)
Hello, without your profile it is impossible to give a completely accurate opinion. Your frontal after photo looks good.
You have outlined a very sophisticated and complex operative nasal procedure. The only thing left that I can recommend is nostril narrowing by Weir excisions which if done properly should not leave a notch in the alar rim.
Can nostril size be decreased and tip sutured smaller in revision for thick skin patient?
I think that your goals are achievable with regard to tip refinement and nostril size.
Find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties and rhinoplasty revisions each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.
Kenneth Hughes, MD Los Angeles, CA
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Widened nostrils after rhinoplasty
Disaster may be too strong a word since the pictures show essentially normal contours. I assume you had surgery to improve airway function; hopefully your breathing has improved. If there are cosmetic concerns you can have them addressed in a straightforward manner. If you don't like your surgeon get another opinion.
Be sure to consult a surgeon certified by the American Board of Plastic Surgery, and insist on seeing a comprehensive portfolio of pre- and post-op pictures so you can see the types of results that are reasonable to expect. Your best bet is to be sure to see someone who has a lot of experience with revision rhinoplasty.
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.