Is it still possible to correct asymmetrical nostrils? What are my options, now 4 months post op?

Hello,
In my experience, nostril asymmetry is usually present prior to surgery.  This is something that would be confirmed with your preoperative photos.  Many times, surgeons do not address the problem during the rhinoplasty and the problem persists.  At four months from your surgery, there is still swelling in the tip of your nose.  This may contribute to the asymmetry as well.  Confirm with your surgeon that this is a problem present before surgery and allow him to review options to correct it as there are several. 
Best of Luck,

Yes, you can correct the nostril asymmetry, but you need to wait for the tip swelling to subside in order to more accurately evaluate what needs to be done.  Changes in tip shape as swelling subsides can at times affect tip projection and nostril size/symmetry.  I would wait until 9 to 12 months after surgery to evaluate.

Nasal healing really does take up to a year after surgery, and while the nostril shape and size can be changed relatively independently from the rest of the nose, this local anesthesia revision (Weir excision) should be delayed so that the best result (improved symmetry) can be achieved.Weir excision involves incisions along the nasal ala-cheek interface, and removal of a small bit of the nostril sill tissue, narrowing and improving the shape and size of the nostril to better match its opposite side. The resultant scars are usually nearly invisible once fully matured, and the improvement can be dramatic. Absolute symmetry may prove to be an elusive goal, but much improvement can be expected from the present appearance.But only if your surgeon is not operating on a still-changing nose. Let it continue to heal and soften for another 8 months. You can make arrangements for surgery and see several additional plastic surgical consultants in addition to your own rhinoplasty surgeon to ensure the surgical plan is correct and makes sense to you. Best wishes! Dr. Tholen