Assymetrical nostrils 8 months post op. What type of procedure can fix this? (photos)

Nostrils, in general, are never precisely symmetrical down to the millimeter: if one divides the nose in half, the nostrils are not twins, but sisters. Having said that, however, it appears from your photos (and not having the opportunity to examine you), that there is a noticeable notch in the left nostril that makes it appear quite different from the right. If this was not present preoperatively, it could likely be repaired with a curved piece of ear cartilage to roll out a little more skin with alar support on that affected side. Your doctor is correct in that one usually waits approximately one year for revisionary surgery; however, I do not foresee this issue getting better during that time, because the notch is already present. Patients come to me often with such issues that they have encountered, having had surgery elsewhere. The good news is that it is correctable.

Hi there,
This is a relatively common complication/side effect of a rhinoplasty. There are a lot of factors that contribute to the potential causes of this. In my experience, there are a few common reasons.

1) The healing process itself. As your surgeon noted, its possible and likely this will even out
2) The scarring of the incision - you may have had an incision around the inside edge of your nostril, and one side may be tighter than the other sometimes this will relax over time; other times, treatment with a steroid injection may help
3) Its possible your nostrils were like this pre-surgery, so its important to consider that
4) It's possible that one side was stitched a little tighter, and therefore, you may need a minor revision

In my experience, many people realize that their nostrils were like this in the first place and may not be easily changed. It's a challenging procedure to do if your nostrils were this way before surgery, but some things can be done.

So, as you can see, many potential causes will resolve on their own, so I always tell my patients to be careful and patient.

We can see that your left nostril margin is a bit higher than your right on front view. In our experience, microdroplet Silikon-1000 injections maybe helpful for lowering the high side for a more symmetrical nostril appearance on front view. I hope this helps. Sincerely, Dr Joseph

Alarplasty can help with grossly uneven nostrils but for mild asymmetry its best to leave it alone. In your case one side is a little higher. Wait for one year and then either bring down one nostril or raise the other.
Regards
Dr. Janjua

Hello and thank you for your question. Based on your photograph, you may benefit from a an extended alar contour graft to help correct your nostril asymmetry. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon