One of my Nostrils is Higher and Less Attached Than the Other. Can This Be Fixed?

I read your concern and reviewed your photo. In my practice, I have had good success, and many happy patients lowering nostril margins with Silikon-1000, an off-label permanent filler. I've attached a photo from my RealSelf gallery demonstrating this effect.

I hope this is helpful for you.

Although the degree of asymmetry can reduced with an alar-facial groove incision and lower lateral cartilage rim graft, perfect symmetry may be difficult to achieve.

This can be improved with a nostril only operation. However, the nostrils will never be perfectly the same. See an experienced rhinoplasty surgeon.

It looks as if you have a slight facial asymmetry where the left side of your face is a little smaller than the right.  This causes the nasal tip to lean towards one side. The septum typically leans as well in those situations. This results in mild tip deviation and nostril asymmetry as you have shown in the photograph. The facial asymmetry also typically causes one nostril to look attached at a higher or lower point than the other.

A surgery including septoplasty and a small graft underneath your nostril attachment can typically correct this quite nicely. The other option is to have some filler injected underneath that nostril and see if the new appearance is what you were hoping for.

Best of luck

Hi Snow,

Best to consult with a few rhinoplasty specialists.  Choose your rhinoplasty surgeon most carefully.  Good luck and be well.

Dr. P

If the offending problem is a crookedness of the caudal septum, this can be adjusted. It is extremely difficult to try to adjust nostril sizes. Occasionally a unilateral alarplasty can be done to narrow a wide nostril.  

Correction of uneven nostrils can often be a challenging procedure.  They can often be made more symmetric with a surgical procedure, similar to a nostril narrowing procedure.

From the one picture provided I would say that the asymetry you are concerned with is well within the normal asymetries (assuming no prior surgeies) everyone has to some extent between the two halves of the face. It is barely noticable. Fixing this is not easy matter and unlikely to give a "perfect" result. Leave it alone.

Hi Snow589 in Maine,

I agree with my collegues that asymmetry is not only in the nostrils, but also the face. Facial asymmetry is very common, and may not be appreciated until one visits the plastic surgeon. Facial asymmetry contributes to the nose leaning to one side. In addition, the nasal septum is deviated as well causing the tip of the nose and nostrils to be uneven.

Plastic surgery treatment would involve a septoplasty with rhinoplasty. Small grafts may be required around the nostrils to further improve symmetry. While the goal is perfect symmetry, there may always be a degree of irregularity despite treatment. Only after a comprehensive evaluation can a plastic surgeon or rhinoplasty specialist help determine appropriate options for you.

Best of luck
 

Dr. Chaboki

Alar rim grafts and composite grafts can help lower your nostrils through rhinoplasty. Remember though that every person is asymmetric and this is built into our neuroanatomy to choose asymmetrically our mates. I don't see that the attachment is much different from each side but other pictures would help. Alar rim grafts are cartilage grafts that are put along the nostril margin or rim (hence called rim grafts) to help lower the rim. Composite grafts are made up of ear cartilage grafts that are a composite of skin and cartilage. This combination allows you to lower the rim even more when this is incoporated.