Will Alarplasty Help Fix my High, Flared, Uneven Nostrils? What is Likely Causing This Asymmetry? (photo)

In your case, an alarplasty alone would not help.  In general, an alarplasty, or alar base reduction will help reduce the size of the nostrils, making them less wide.  Your nostrils do not appear too wide, but appear to be receding upward.  Sometimes, when patients have nostrils that flare, it can create the illusion of a hanging columella.  The best way to achieve balance in this area is to use cartilage grafts to lower the nostrils.  I would recommend a consultation with a board certified surgeon that uses computer imaging software to help get an idea of how your nose may appear following a surgical procedure. Thanks, and I hope this helps answer your questions.

Dear Asymetrique,

 

Thank you for sharing you photos.

 

I recommend a multifaceted approach when it comes to your case so all your nasal aspects could be addressed proportionally and will better fit your facial features while preserving the natural beauty of your face.

 

Without physical examination it is difficult to give you solid planning on how to go about realizing your goal.

 

So, it is best if you could seek a consultation with a board certified surgeon of ample experience in the field who will guide you and help you make a well informed decision.

 

Best of luck to you.

Dr. Sajjadian

Nostril Asymmetry.  Asymmetry in any part of the nose is essentially due to two basic underlying causes:

·         Developmental causes in which growth of one side is different from the other side.  In the case of the nostrils this can result in lower lateral cartilage that is more retracted, more arched or attached at a different point to the lip-cheek-nostril complex than on the other side.  Developmental asymmetry is very common not only in the nose but other parts of the face and body.  If you look carefully, some degree of asymmetry is present in the majority of humans involving one body part or another.

·         Acquired causes which are the result of past trauma or surgery.

 

In your case, the front and base views you have provided are good but slightly rotated and therefore it is difficult to make an assessment with 100% accuracy.  Despite this it would appear that the main issue appears that the right nostril margin is retracted upwards more than the left.  In addition the asymmetry may extend somewhat to involve the domes of the nasal tip. Additionally, the columella of your nose demonstrates a mild degree of excess downward extension also known as a hanging columella.  This contributes to excessive nostril show but not to the asymmetry.

If you desire to address only the alar rim retraction on your right side, a simple alar rim graft done through a closed approach will go a long way to improve asymmetry.  The hanging columella can also be corrected with this simple approach.  Such surgery can be easily accomplished in a 45 minute procedure using oral sedation and local anesthetic. 

If, on the other hand, you wish to address other issues such as nasal tip width, volume, asymmetry and definition, then I would recommend an open technique to remodel the nasal tip.  Such an approach can improve the balance of the upper half of your nose with the lower half.  I strongly urge you to consult with a surgeon willing to review the possibilities with computer image simulation software.

 

Mario J. Imola, MD, DDS, FRCSC.