Nostrils look significantly uneven. Can I avoid a 3rd revision rhinoplasty? (Photos)

Question

I had a second revision rhinoplasty 7 months ago to correct graft work from a previous surgeon and address nasal collapse from my first procedure. Unfortunately, my nostrils still look significantly uneven. Is there any way to avoid a third revision? Could a surgeon potentially shave or sculpt the scar tissue in the smaller nostril to better match the right side? I'm really hoping to avoid going through another surgery.

Gianfranco Frojo, MD · Answer

You are still very swollen. Most revision rhinoplasty patients (in my practice) require 2 years of edema (swelling) management / observation after surgery to see the final result. Some of the asymmetry may be related to the swelling. I would definitely express your concerns with your revision rhinoplasty surgeon. If you are concerned that the journey/recovery is not going as you anticipated after your discussion...I would recommend a 2nd or even 3rd opinion from an American Board of Plastic Surgery cetified plastic surgeon with extensive expertise in rhinoplasty (especially revisions).

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.
As far as I can see from your photos full equality can never be achieved due to facial asymmetry. After consulting with your surgeon on the subject, it would be correct to talk for revision rhinoplasty after your 1st year has expired.
Best Regards!

Tanveer Janjua, MD · Answer

It is almost impossible to achieve nostril symmetry. Any attempts can lead to taking too much off one side and then going back to take some more from the other side. As this goes on permanent scarring with poor healing can lead to worst asymmetry than before the surgery was done. 
Also, it is very important to remember that nobody will look at your nostrils from below. From the front view the nostrils don't look as asymmetric as from below. Unless the asymmetry is really obvious and disfiguring, it should be left alone.

Regards
Dr. J

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you may benefit from another revision rhinoplasty to help correct your nostril asymmetry. Placement of extended alar contour grafts and tensioning the tip would likely help this. 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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