6 months post-op, is it normal to have nostril asymmetry after significant tip work? (Photos)

Question

My nose tip tilted to the left and after rhinoplasty about 6 months ago to straighten it, my left nostril is narrow and pointy, which I hate, compared to my right nostril. My surgeon said she could do alarplasty on my right nostril so it would match my left nostril but I’m afraid I would then hate both my nostrils. She said it would be more difficult to make my left nostril match my right one. I would be ok with the asymmetry if it didn’t make my nose look so weird when I smile.

Thomas J. Walker, MD, FACS · Answer

I recommend you seek the opinion of a revision rhinoplasty expert in person and possibly. I am not certain if an alarplasty is the solution, nor should anyone make a recommendation via this forum. You need to be evaluated in person, look at the entire nose and face, and come up with a game plan. I do believe that your nostril asymmetry can be improved.

Best,
Thomas Walker, MD, FACS
470-900-3223
@drthomaswalker

Anil R. Shah, MD · Answer

Hello,

I wouldn't recommend waiting for the full year to determine how your nose and smile changes with your procedure. One problem with doing a alarplasty is that your nostrils don't appear to be that different straight on and you risk creating further asymmetry. You can consider botox to the muscles around the nose to see if that helps the asymmetry from the smiling. You can also place a suture inside the nose called a sin suture to help prevent the nostrils from moving. Good luck!

Eric M. Joseph, MD · Answer

Postoperatively, I can see your concerns about nasal tip asymmetry that is worsened with smiling. Personally, I do not believe that narrowing your right nostril would do any thing good for your concern. Since you are on the downhill stretch for swelling, I don't think that this will spontaneously improve. Depending on your examination, you may be a candidate for a permanent non-surgical nose job to perhaps add missing volume to your tip where it could be used for restoring symmetry. Revision rhinoplasty may be a last resort. If you are not having a good feeling about what your surgeon is recommending, sometimes it's helpful to get a copy of your operative report and to get a second opinion. Wishing you well moving forward. Sincerely, Dr Joseph

Selcuk Yazan, MD · Answer

Congratulations on your procedure!
To best decide what to do next, it’s important to take a look at what’s going on underneath. 
This is anatomical and unrelated to surgery. Gentics are the most likely culprit with one sides’ muscle being longer/shorter or more dominant/stronger. The effects can be enhanced or made more visible after plastic surgery, as you now have a beautifully symmetrical result while resting. The stronger one of the 2 muscles seems to be pulling up the ala when you smile.
We have 2 muscles on either side of the nose, the levator labii superioris nasi alaeque muscle. They stem from the eye area (nasi alaeque muscle) all the way to mouth area (orbicularis oris), which attaches to the ala and is pulled when smiling, speaking, chewing etc. 
This decision is best to be considered by yourself, the patient, and evaluated by an expert in revisions if you opt to move forward. 
Take your time and enjoy your recovery period

Gurkan Kayabasoglu, MD · Answer

Hello. Alarplasty performed on you will never yield results. Please do not incise your skin. The reason for the asymmetry that occurs only when laughing is that the muscle called mucsle levator superior alaque nasi on one side works more. The dynamic rhinoplasty we perform for this purpose is the only procedure that can give you the result you want.

If you want to get more information, you can always reach my assistant Dila on this number +90 533 015 95 95 via WhatsApp and ask any questions you have in mind.

6 months post-op, is it normal to have nostril asymmetry after significant tip work? (Photos)

Answers (5)

Answer: Nasi alaeque muscle

Answer: Nasi alaeque muscle

Answer: Alarplasty will make it worse!

Answer: Alarplasty will make it worse!

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Everything you need to know about Rhinoplasty

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6 months post-op, is it normal to have nostril asymmetry after significant tip work? (Photos)

Answers (5)

Answer: Nasi alaeque muscle

Answer: Nasi alaeque muscle

Answer: Alarplasty will make it worse!

Answer: Alarplasty will make it worse!

Browse related questions

Recommended reading

Everything you need to know about Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.