Fixing Asymmetrical Nostril on Child

Hi,

Yes it can be fixed.  One of the world's experts in nose reconstruction is Gary Burgett, MD in Chicago, Ill.  Good luck and be well.

Dr. P

The notch in the rim of the nostril is associated with a deficiency in skin and underlying cartilage. I am posting a picture called nostril notch repair to the real self website. If you look at the photo you see an area outlined on the lower edge of the notch. This is cut leaving the very edge intact so it can be swund down. A piece of cartilage from the ear is then sutured on top of that. Then the higher skin marking is cut so the outer skin can be rotated downward to cover the cartilage. Since this is not performed at the growth center of the nose I don't see why it could not be done right before he starts school. It should not affect nasal growth as he matures.

Defects of the alar rim (nostril edge) are more commonly seen with skin cancer and injury than at birth. The way they are commonly fixed is with a COMPOUND GRAFT borrowed from the rim of one of the ears, leaving a tiny scar on the ear. To minimize size discrepancies and notching this is best done when the nose is close to normal size. but obviously this needs to weighed against the psychological trauma and potential behavioral issues that may be seen if you wait for the ideal time.

When face with a significant cosmetic congenital deformity, the contradicting factors are growth concerns and psychological trauma. Since the nose is still growing, it is ideal to wait until the nose is fully formed in the late teen years. However, the psycho-emotional  trauma of living with such an obvious deformity may be more severe. I would advise watching for signs of this in terms of behavior or maladjustment. If he is socially normal, making friends, exhibiting confidence, etc. I would continue to wait. If he shows behavior that is of concerns in terms of difficulty with other kids, being withdrawn or angry, or certainly if he is making comments about his nose, some treatment  may be indicated earlier.