1 year post op, What's Wrong with my Nose? (photo)
Doctor Answers 5
Nostril-Columellar Adjustments after Open Rhinoplasty
Unfortunately you have suffered not uncommon nostril-columellar distortions that can happen after any open rhinoplasty. Some minor adjustments can be done that don't require another open rhinoplasty including an alar rim cartilage graft for the left alar rim retraction and an inward movement of the soft tissue triangle and the columella on that same side to try and improve your symmetry. Your morphing image is a good goal and may be able to be achieved or gotten very close to resembling.
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Alar retraction and depression.
You will need to have a revision with cartilage and or soft tissue added. See a very experienced rhinoplasty surgeon for best results.
Your left nostril rim has retracted after the rhinoplasty surgery. This can be a side effect of several of the techniques used to narrow a nose tip.
It can be modified by adding cartilage, but that would be another rhinoplasty operation. The modification would be likely to help improve the retraction but I would expect that you would still be able to find differences between the two sides.
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Left Nostril Rim Retraction
The left nostril has retracted (elevated) after your primary rhinoplasty. This can be corrected with a small alar rim cartilage graft taken from your septum or ear. The morphed results are very realistic. In 35 years I've never seen fluid under the tip a year after surgery; I'd have to examine you to answer that question.
What's Wrong with my Nose?
The tip can be elevated and refined a bit. However, an exam and pictures from different angles will be necessary to determine what maneuvers would be best employed. Find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results. Kenneth Hughes, MD Los Angeles, CA