Alar Collapse Possible After Fourth Rhinoplasty?

This is my fourth Rhinoplasty. I had open rhinoplasty (two weeks post op). Everything seems okay except for nostrils. I'm noticing that one nostril is slanting in and other is straight up (it's not noticeable looking at my face, but when I lift my head up, I can tell).

My ENT said he will have to monitor my nose from collapsing because first plastic surgeon took all my cartilage to build up tip and dorsum. Will nose collapse within next couple of months or much later? I don't want another surgery!

What are the signs of alar collapse? Do I have the first sign of one nostril slightly slanting inwards? Will my breathing diminish over time? Is there anything I can do so I don't have to have another surgery?

Read my review "Third Revision Rhinoplasty - Worried About Nose Collapsing (Alar Collapse)"

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3 Doctor Answers | Asked by hisako in hawaii

Doctor Answers (3)
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Fourth revision rhinoplasty.

I hope you get an excellent result! I'm glad your surgeon will monitor you closely. If you're breathing well through your nose, you won't need any further surgeries. In fact, a 5th surgery could lead to severe problems. If there are any visible signs of collapse due to insufficient cartilage, you might benefit from injectable fillers, in the future, to restore symmetry. Now it's too soon to tell. Good luck, and best regards.

Eric M. Joseph, MD

197 reviews

West Orange Facial Plastic Surgeon

www.ericmjoseph.com

2 weeks after 4th Rhinoplasty

Hisako- At only 2 weeks from your 4th revision rhinoplasty, I imagine you understand your healing process has only just begun. Much healing has yet to be occur! Because of your prior surgeries, we might only speculate on what may be causing the nostril asymmetry: It could be just swelling, or early asymmetry from cartilage grafts, tip sutures, or loss of support from weakened domes. Asymmetric rim grafts can also make it appear that the nostrils are asymmetric. Only your surgeon knows... more

Alar collapse is possible but there are ways to help prevent

Ask your surgeon about inserting a plastic stent-like device that would sit, hidden, inside the nostril and help prevent overtighting that might cause the collapse. It is important to do as much as possible to prevent that, particularly after several surgeries. The doctor will be familiar with the types of stents, ring-like insertable and removable, devices that are available ro which can be custom made. To give you an idea as to the nature of these, check out: Max-Air Nose Cones. They... more