What can be done to make my nose straight and nostrils symmetrical? (photo)

I've had 2 rhinoplasty's. The first one was purely cosmetic, in 2007. Eventually, I was noticing trouble breathing from my right nostril and had a revision in 2013. For the revision, the doctor used cartilage that was in my nose to create the graft. Yes, I can breathe through my nose but I am unhappy that my nose veers to the right and my nostrils are not symmetrical. There is also quite a bit of scar tissue inside my nostrils.

Doctor Answers 3

Shortening your nose would help a lot in making it symmetrical

See the "Web reference" link, just below my response. I made a couple of computer morphs of your nose, and animations of the morphs, to show the changes that are possible for your nose in truly expert hands.

Besides adding symmetry to the frontal view, I elevated the tip. Just moving the tip back to the left can be extremely difficult to accomplish, but when we are doing something else to the tip at the same time, such as narrowing the tip and/or elevating the tip, that gives us more techniques to use, more possibilities to get the symmetry improved.

You'll see on the three-quarter view that I simulated elevating the tip, narrowing it, and also narrowing and lowering the bridge. Another trick to decreasing asymmetry is to make the entire nose smaller, as I simulated: if the nose is smaller, asymmetries look smaller, too.

In looking at my modifications, I think the goal could be to elevate the tip even more, depending of course on your preferences.

You should understand that the changes I demonstrated in the morph require advanced techniques, techniques that most plastic surgeons cannot handle.  Be sure to read the section in the "Web reference" link on how to stay out of trouble while searching for a rhinoplasty surgeon.

Your nose is also a good example of why computer imaging is mandatory in rhinoplasty. You need to know exactly what the surgeon is planning to accomplish -- what features he thinks he can change, and by how much he thinks he can change them. When you see his goals, you'll know whether he has an eye for a beautiful nose, and whether he shares your opinion of what constitutes a beautiful nose. You'll also know whether the changes he proposes are enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. But remember, you're not hiring him for his skills with the computer. The doctor must then show you his before and after photos to prove that he can actually accomplish what he draws on the computer.

Omaha Facial Plastic Surgeon
4.8 out of 5 stars 41 reviews

Revision rhinoplasty candidate for the crooked nose

A revision rhinoplasty can accomplish straightening the crooked nose. Improvement but not perfection can be accomplished with the asymmetrical nostrils. To straighten the crooked nose usually requires osteotomies placed in the nasal bones, a cartilaginous spreader graft placed underneath the concave upper lateral cartilage in the midportion of the nose, and a tip rhinoplasty when the tip cartilages are asymmetric. It's important to know how much cartilage is left on the inside of the nose for grafting purposes from the two previous rhinoplasty procedures. For more information and many examples of crooked nose repair in our practice, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Rhinoplasty revision for the crooked nose etc.

Rhinoplasty revision for the crooked nose with residual hump and asymmetry. These can be corrected with a revision rhinoplasty done by a very experienced revision rhinoplasty specialist who does NATURAL noses and not the overdone look. Look at the results of revision noses on the websites of revision rhinoplasty experts and choose several to see.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.