Nostril Support Issue After Revision Rhinoplasty

weeks post-op one nostril almost completely closes (about a 1 mm gap is left open between the inner nostril and the columella) when I breathe in hard enough, it also opens a bit too much so inside of the nose is visible, the other nostril is normal.It appears that some support was taken out closer to the tip which made the half of a nostril closest to the tip softer. Is it a serious concern (will it improve later on or not or get worse) and how correctable is such a thing? Thanks in advance.

Doctor Answers (9)

Correction of nostril collapse in revision rhinoplasty

+3

It sounds very much like you have lost support on that side of your nose, which can happen if the lower lateral cartilages of the nose are significantly narrowed during the primary rhinoplasty. This causes pinching of this side of the nose as well as the nostril rim retracting upward, allowing more of the inside of the nose and columella to be visible from the front or side. The issues are certainly correctable but are unlikely to improve on their own without revision surgery and may, unfortunately, get worse with time.

The pinching can be corrected by reinforcing the lower lateral cartilage with what we call a lateral crural strut graft, taken from your septum. The nostril rim can be lowered with placement of a thinner cartilage graft, called a rim graft, along the inside of the nostril. Alternatively, for cases of severe retraction, I place of a graft of skin and cartilage (composite graft), which can be taken from your ear without changing the shape of the ear much at all. 

Discuss the issue with your rhinoplasty surgeon or, should you decide to get a 2nd opinion, be sure to consult with a revision rhinoplasty specialist

Best wishes,

Dr. Mehta


Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 25 reviews

Can nostril collapse be corrected?

+2

It does sound like you're experiencing some loss of tip support in the area of that nostril. It's difficult to say for certain how it would be best to correct, but there are several methods available. Mostly it involves grafting cartilage to the area to give additional support.

If you're only a few weeks from surgery it'd be best to discuss the issue with your surgeon. You'd likely want to allow your nose to heal further to see how things progress.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Collapse of nostril after rhinoplasty

+2

Dear revision rhinoplasty patient from Toronto,
According to your description, you have a “pinched” nostril on the left side. This is usually due to over resection of the lower lateral cartilage, resulting in collapse of nostril. A batten cartilage graft can help to resolve the problem. This can be done under local anesthesia, utilizing ear cartilage.
 

Kevin Sadati, DO
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 86 reviews

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Change in nostril after rhinoplasty

+2

Without examining you, it is difficult to provide you with a definitive answer. However, it sounds like there has been some loss of support in the nostril. This is often due to a change in the cartilage. Fortunately, this can be corrected with cartilage grafts, such as an alar rim graft. I would suggest following up with your surgeon to discuss this. Your surgeon will then help to diagnose the cause and discuss any possible treatment options.

Ryan Greene, MD, PhD
Fort Lauderdale Facial Plastic Surgeon
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Unilateral Nostril Collapse

+2

If you have a decrease in nostril support on that side after revision rhinoplasty, a cartilage graft can be placed to correct the problem.  It is not clear on your post when the surgery was done, but discuss your observations with your surgeon during your next visit.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
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Loss of nostril support after revision rhinoplasty may be a concern!

+2

This may be a sign of over-aggressive cartilage and/or scar removal from your first rhinoplasty surgery. Depending on how you heal, continued loss of nostril support can indicate a problem that may require being addressed. However, if you form hard or thick scar tissue, you may note improvement in your nostril rim stiffness and improved airway patency.

This is something best discussed with your surgeon. If you do not feel you are getting the answers you need, seek a second opinion form a board-certified, experienced revision rhinoplasty expert. Best wishes!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 109 reviews

Nostril collapse after surgery

+1

The bad news is this will likely not correct with time, and may possibly worsen - the good news is that there is a good solution for this using structural cartilage grafting

Sam Naficy, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 132 reviews

Options for "flail" nostril after nose job (rhinoplasty)

+1

There are a variety of grafts such as a lateral crural strut graft or marginal cartilage graft or even a composite graft which could provide you with an improvement in the problems you describe.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 41 reviews

Rhinoplasty

+1

You had over resection of the lower lateral cartilage which also gives support to the nostril. Now you have a collapse of the nostril.

You will require surgery and cartilage graft to correct  your nostril collapse

Samir Shureih, MD
Baltimore Plastic Surgeon

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.