Can this be an alar pinching/ collapse? (Photo)

I had an open septorhinoplasty exactly 4 weeks ago to correct my deviated septum as well to make my nose straight. What I wanted was to be able to breath and a straight nose which was discussed with the Dr. My left nostril seems wider now. That nostril had always been bigger but was never that noticeable. Will the nostril shrink more or will this definitely need a revision? My surgeon says I need to do a massage on that nostril, 3 x day. I'm afraid this will make it bigger! What are my options?

Doctor Answers 3

Collapsed sidewall versus a sidewall that is to big?

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I do not understand your pictures. If your final picture is the one on the far right then wait and internal scar contracture should bring the sidewall down. It is difficult, if not impossible, to create a wide flaring alar sidewall from a normal nose unless major bone/cartilage grafting has been employed and even then I wouldn't count on the sidewall to stay out. If however your final photograph is the lower row far left then too much cartilage support has been removed and you have the opposite problem. The lack of sidewall support will require the addition of some cartilage, i.e. septal if it hasn't been removed to correct a "deviated septum", or perhaps even rib cartilage.Finally, to help your breathing problems the base of the center of your nose, called the columella, is shaped like an upside down "V" which should be straight. The footplates of the cartilage flare into your airways and probably obstruct your inhalation, especially forcefully.  

Atlanta Plastic Surgeon
4.9 out of 5 stars 61 reviews

Nose Surgery - alar pinching

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At 4 weeks after surgery, there is nothing to do at this point.  If I understand your pictures correctly, your columella seems swollen and your left nostril seems to be collapsing.  The swelling will pass.  What is concerning to me is the collapsed look that may be due to over resection and lack of alar rim grafts at the rim of the nose.  I would bring this up to your surgeon and discuss your options for the future after you heal.  Best Wishes!!

Be patient!

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Being only 4 weeks after surgery, some of the issues should get better, but it will take 3-6 months for all of the swelling to go away.  If after that time period, you still have some of the issues that you are concerned about, please speak to your surgeon about these concerns.  I see a collapse of the left nostril suggesting inadequate support in this region.  But be patient!

John Frodel, MD
Atlanta Facial Plastic Surgeon

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