Alar rim nostril fix? Is there a surgical option that can be done under local anesthesia? (Photo)

Question

i had a rhinoplasty which causes alar rim retraction, i then had silikon 1000 places on both side to correct the problem, however now my right nostril was over corrected. is there a surgical fix for this that can be done under local anesthesia. Filipino doctors say it’s possible but the american doctors i have found seem to be hesitant.

Ali Sajjadian, MD, FACS · Answer

Thanks Intelligent131677 for your question! Alar rim overcorrection can be corrected surgically, and certain procedures can be carried out under local anesthetic. The following are some options:   
-Cartilage Grafts: To stabilize the alar rim and reverse the retraction, tiny fragments of cartilage—typically from the septum or ear—can be positioned carefully.  Occasionally composit graft from ear including skin and cartilage is used. 
-Fat Grafts: To restore volume and improve the shape, little quantities of fat may occasionally be taken from another part of the body and injected into the alar rim.
-Revision Rhinoplasty:  revision rhinoplasty methods might be taken into consideration, depending on the precise reason for the overcorrection. These include:
-Alar Base Refinement: To enhance symmetry and balance, the alar base's location may need to be changed.
-Columellar Struts: To enhance tip projection and offer support, tiny cartilage grafts are inserted into the columella, the vertical band of skin between the nostrils. Sometimes septal extension cartilage grafts are used.
The suitability of local anesthesia will depend on the complexity of the correction and the patient's individual preferences and medical history.
Seeking advice from a skilled, board-certified plastic surgeon with expertise in rhinoplasty is essential. After giving your nose a thorough examination, they will talk with you about your areas of concerns, goals and desires and suggest the best course of action for you.   
It's critical to approach any surgical treatment with reasonable expectations regarding its results.
As a triple Board-Certified Plastic Surgeon and experienced rhinoplasty surgeon, I specialize in revision rhinoplasty. This complex procedure requires meticulous attention to detail and a deep understanding of facial and nasal anatomy. I am committed to correcting imperfections and restoring both the form and function of the nose. My philospphy is to listen carefully to the goals and desirers of my patients with a focus on patient satisfaction, I utilize advanced techniques to achieve natural-looking and long-lasting results.
Hope this was helpful!
Best wishes,
Dr Ali Sajjadian

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photograph, you may benefit from a revision in order to help improve your nostril asymmetry. Placement of extended alar contour grafts would be very helpful. This should be done as a formal revision and not under local anesthesia for the best results.. 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

Best wishes and good luck.

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

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