I've had two prior rhinoplasty's and the last one resulted in uneven nostrils. Is there a chance they can be evened out?
Can my Uneven Nostrils Be Evened? (photo)
Doctor Answers (7)
Based on your picture, it is difficult to say. It very much depends on the amount of asymmetry going on. It is natural to have some differences in nostril shape and size. If you're unhappy with the results and decide to proceed with surgery, revision alar base surgery may be beneficial.
Making uneven nostril more symmetric
It may be possible to address your nostril asymmetry. The main issue is that your columella is somewhat deviated to your right side.
Check out my web reference below to learn more about the repair of nostril asymmetry.
Pictures of your profile and the base of your nose would help us answer your question. Your nostrils are asymmetrical and the nostril rims appear to be retracted. This can be improved; if you do not use your surgeon consult with a surgeon who specializes in revision rhinoplasty.
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Nostril shape and rhinoplasty
nostril shape and size is one of the more difficult things to control in rhinoplasty in my opinion. the level of difficulty increases as we consider secondary rhinoplasty.
with that said - your left nostril appears a little wider. if this did not exist prior to your rhinoplasties it might be that your nose tilted to your right prior to the surgeries. then when your tip was brought back to midline the larger nostril "appeared." i see this happen from time to time and believe it is due to the nostril being "stretched" by tilt/deflection. anyhow, now that your tip is more or less at midline the left nostril appears slightly wider. if i were to see you in my office and confirmed this with additional views and exam, i might offer a very slight (1-2mm) alar base reduction on the left side only. this can be very powerful tool that it seems like many surgeons avoid. patients seem to be apprehensive of it too. but i will say that the incisions/scars associated with this are extremely difficult to see (even when patients come back as early as one week - because i use fast absorbing suture there i sometimes have to remind myself i even did a alar base reduction, the scar become very inconspicous) and they are well hidden in a crease too.
in your case this might be done under local and take only a few minutes.
by the way you may have alar retraction as others have mentioned (i am not convinced of it however due to the fact that a lateral view is not shown - impossible to commment confidently without that)
While the view you posted does show some nostril asymmetry, other views would be helpful along with a more detailed history.
Nostril asymmetry and alar retraction after rhinoplasty
More than the asymmetry of the nostrils, the amount of alar retraction (nostrils pulled up) brings unwanted attention to your nose. Asymmetry is always present before surgery, and always present to varying degrees after surgery. The symmetry of your nostrils can probably be improved, but more importantly the alar retraction can certainly be reduced.
Asymmetry of the Nostrils Following Revision Rhinoplasty
The answer is - yes - things can be made more symmetrical in terms of the nostril shape and size. However, you might want to also consider bringing the nostril rims down a little on both sides if you undergo revision surgery. This will probably require what are called composite grafts.