I had a open rhino done a month ago to shave the dorsal hump, break the bones on both sides of my nose, and heighten my tip with cartilage taken from the inside of my nose. When I took a picture right after surgery, I realized that my nostrils were uneven but waited patiently for the swelling to subside. During my fourth followup yesterday, he said it may have been due to the splints placed unevenly or the stitches stitched too tightly on my left nostril. Does this mean I have to do a revision?
During Open Rhino, Will Stitching the Incision on One Side of my Nostrils a More Tightly Than the Other Make It Uneven? (photo)
Doctor Answers 7
Early asymmetry after a rhinoplasty
At one month you are too early to begin to judge the final result. I would doubt that closing the skin too tightly on one side would make any permanent difference.
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Nostril Asymmetry and Rhinoplasty
At one month, it is still really difficult to determine what your long term results will look like. I final judgement can be made closer to 9-12 months. Keep communicating with your surgeon and be patient. That said, if you have early nostril asymmetry a few reasons come to mind. If everything looks symmetric and straight, but the nostrils are slightly uneven toward the middle of the nostrils then a base suture or medial crura footplate suture can be to blame. Both of these should get better with time. Your surgeon has the best insight into what he/she thinks could be the cause based on the maneuvers her made. I hope this helps. Take care.
It is too early to do anything about tip asymmetry. You need to wait at lest 4-6 months for the majority of the swelling to abate. However early asymmetry is not a good sign and more often than not will persist. Most highly experienced rhinoplasty surgeons know tip asymmetry is usually caused by asymmetry itself in the lower lateral cartilages or weakness in these cartilages. If this is the case and it most probably is you may need adjustment of these cartilages and /or grafting for stabilization and strength.
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You are still in the early post op period. The asymmetry may continue to improve over time. You need to wait a year before any revision if needed. Donald R. Nunn MD Altanta Plastic Surgeon.
Nostrils uneven after rhinoplasty?
This is actually a fairly common complaint early after rhinoplasty as patients get out their "microsope" and check for absolute a perfect symmetry. This is a somewhat unrealistic goal in the early going. What you should instead be asking yourself is about how the overall appearance is from the front, side, and oblique view. Not many people are going to be staring up your nostrils. If your nose looks improved from these angles that normal conversation takes place then you likely had a good job and should be satisfied once the swelling goes down which can take 6 to 9 months.
One Month After Rhinoplasty
One month after a Rhinoplasty is a little early to make judgments on whether you will need a revision. Although there may be aspects of your procedure you are currently unhappy you are likely to see significant changes in your nasal appearance as the months go by. This asymmetry may or may not improve, but it would be unwise to address surgically at this time.
During Open Rhino, Will Stitching the Incision on One Side of my Nostrils a More Tightly Than the Other Make It Uneven?
At one month, you could have residual swelling that is altering the appearance. The picture is a bit out of focus, but I would probably not revise anything at this early stage.
Kenneth Hughes, MD Los Angeles, CA
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