Septoplasty has left my left nostril larger than before. Is it possible to correct it back to its original size?
Correcting Septoplasty Results
Doctor Answers 6
Correcting Nostril Asymmetry
Nostril asymmetry is one of the most difficult thing to correct. The shape of the nostril and alar base is comprised of the following:
- Shape of nostril
- Shape of columella
- Orientation of the septum (see attached example of deviated base view of septum)
- Thickness of the alar base
- Insertion point on the face
- Shape of the medial crus
- Orientation of the lower lateral cartilages
A surgeon who performs revision rhinoplasty should look at the nose in a three dimensional perspective. This means correcting asymmetry in all of the views including base view, front view, oblique view, etc.
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Yes, it's possible
If the interior portion of the septum is not in the midline it will cause one nostril to be larger than the other. Depending upon the position of the septum, this can be corrected with alar plasty or a revision septoplasty.
Septoplasty (septal deviation correction) may help
This is a question for which patients have been sent to me numerous times....and the answer is difficult even in those situations when I can evaluate the patient personally.
Suffice to say that preoperative photographs and operative notes would help determine (a) if the asymmetry existed preoperatively and (b) what may have caused the asymmetry. In many cases, a correction is possible. If the caudal (bottom) portion of the septum is deviated, it may cause nostril asymmetry. This CAN be addressed in may cases with a functional nasal surgery (septoplasty or functional rhinoplasty).
If the asymmetry is caused by over-resection of the caudal septum, and some nasal tip collapse has occurred, a more complicated approach may be required, including rhinoplasty with some type of cartilage graft.
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Rhinoplasty versus Septoplasty
It would be difficult to make a statement on your particular problem because there is no pre-op photo, but in general, nostril size and shape is something that may look different after your septum has been straightend due to moving that structure, or from edema or swelling of the nostrils.
Usually, patients that point out nostril subleties post-op fail to realize that they were often present on their pre-op photos, and that a septoplasty does not address nostril size or shape, it addresses the midline of the nose. A tip plasty or columellar strut graft may change the area of the nostrils, but those are techniques employed for cosmetic rhinoplasty, not for the treatment of a deviated septum for functional reasons.
Was There Asymmetry Before Your Surgery?
It is difficult to know what nostril shape was present before your surgery and which one has changed, if either, without pre op views of this.
There is a flattening of your right nostril, which is different from the size of your left nostril. Attempting to make them more symmetrical may require surgery addressing your tip structure.