Split Nostrils Post Rhinoplasty - causes/solutions? (Photos)

Nostril retainers is a very weird and non understandable decision, much less when such aggressive alar base reduction was done. To be frank in 25 yrs career I never used nostril retainers applied intraop in one of my rhinoplasties, I don't see the point and they are very very dangerous! Bear with me and you'll understand.

I have the gut feeling your surgeon became aware of his misjudgement at reducing alae and nostrils, from the inatrop image your nostrils are abnormal, rounded, tiny and obviously a source of breathing intake reduction, hence he applied expanders of the nostrils con counter act his surgical action, and these retainers became a conflicting force against the overly reduced nostril rim/sill plus the normal postop inflammation; all in all, you got a pressure sore damage, a skin damage/necrosis due to the compression made by the retainers.

This explains why you had abnormal (rounded and tiny) nostrils in the introp and now have oval and normal-sized nostrils, pay attention to the widening effect at the nostril sill, only attributtable to the mechanical expansion effect of a kind of splint or expander.

There are chances of total or subtotal restoration of that indent at the anterior end of the nostril rims, I strongly recommend being patient and conservative, I am aware it is 1.5 yrs after your surgery, give it up to 2 yrs, and then decide.

Sometimes, indentations at the top of the nostril can be due to taping the nose at the end of surgery. If notching of the nostrils occur, we tend to treat this with microdroplet Silikon-1000 injections for permanent non-surgical nose job treatments. This tends to lead to very high patient satisfaction. I hope this helps! Sincerely, Dr Joseph

Alar notching can happen from lack of cartilage support at the soft tissue triangle. If it does not improve to your liking over time, you can get rim grafts in that area to make it a curve.
Regards
Dr. Janjua

Hello and thank you for your question. Based on your photographs, you may benefit from a revision rhinoplasty with nasal tip deprojection and placement of extended alar contour grafts to fix the soft triangle notching in your nostrils. 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