Revision alarplasty - what procedure is needed? (Photo)

Question

I am 1.5 years post op from my first rhinoplasty, and this is various photos of what my nose looks like now. I believe that I have asymmetrical nostrils in result of an alar rim retraction. I really would love to fix this asymmetry, but what procedure is needed? After doing some research, it seems as if I need an ALARPLASTY, that uses a cartilage graft from my ear. I've read that this procedure costs about $3000? Is this true? If so, why is this price cheaper than a revision rhinoplasty?

Steven J. Pearlman, MD, FACS · Answer

The alar rim can be lowered by adding a graft along the rim. If there is significant differences, you might need a composite graft of both skin and cartilage that is taken from the ear. This procedure takes less than half the time of a full revision rhinoplasty, which is why many surgeons charge less. However if you ahve other issues you might need a full revision rhinoplasty. You should seek out a specialist in revision rhinoplasty for an opinion.

Thomas A. Mustoe, MD, FACS · Answer

It is easy to raise the lower rim with a rim incision and small amount of resection: the scar is not visible.  To lower the higher rim is much more involved.  A cartilage graft from the ear sometimes gives a good result but not always.  It is more predictable to do a formal revision rhinoplasty to reorient the lower lateral (tip) cartilages and add cartilage grafts as well. In your case I am not sure that is worth it.  I would seek more than one opinion with experienced revision rhinoplasty.

William Portuese, MD · Answer

An alar-plasty simply narrows wide nostrils. The photographs demonstrate alar retraction, which is going to require a composite skin and cartilage graft from the ear.

Revision alarplasty - what procedure is needed? (Photo)

Answers (3)

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