I have uneven nostrils (one higher/wider than the other, which splay unattractively when smiling with my teeth. (Photos)

Question

I also have an overactive muscle on one side of the tip. My smile with teeth is what makes me most self conscious, so although I have a small bump on the bridge I'm more concerned with the tip. I have spoken to surgeons who have said rhinoplasty probably won't achieve what I'm after. What are my options?

Guy Watts, MBBS (Hons), FRACS (Plast) · Answer

Thank you for the question and images. From the images you have provided the asymmetry is subtle. I can understand that you are concerned by it and notice it in photo's but I would imagine if you asked a stranger what is wrong with your nose they would likely say not much. From the basil view there is some deviation of you caudal septum into the left vestibule and this may contribute to some asymmetry in the position of the tip. Nasal surgery is good at delivering big changes, but when it comes to very subtle change is can be harder to achieve and perfect symmetry is really not achievable. If you have consulted with a few surgeons it sounds like you have done your homework and if they feel that surgery will unlikely help then it may be worthwhile listening. I think you look gorgeous in your images and have nothing to worry about. RegardsDr Guy Watts

Damien Grinsell MBBS, FRACS (Plast) · Answer

Hi. If it is just the dynamic aspect of the smile that bothers you then this can be softened with botox injections however it can change the shape of the smile.RegardsDamien

Pedram Imani, FRACS, MS, MBBS (Hons) · Answer

Looking at your basal view pictures I can see that your septum is dislocated to the left (your left), this may the be cause of your nasal asymmetry.  I wonder if any of the surgeons pointed this put to you?  Correction of the septum should make the nostrils appear more symmetrical, but not perfect.  Smiling and nasal widening is a fact of nature, it can be changed with surgery or Botox however the results are generally unnatural.  Hope this is helpful.

Somyos Kunachak, MD - Account Suspended · Answer

Hi Maybe87,
From the base view photo of your nose, it seems that you have some degree of deviation on the inferior part of your septum and a slight flaring of the alars, more on one side than the other - septoplasty and a conservative unilaterla alarplasty may be helpful. A personal evaluation is however still neccessary to confirm this.

I have uneven nostrils (one higher/wider than the other, which splay unattractively when smiling with my teeth. (Photos)

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