Congenital Deficiency of Alar Cartilage? How can I get this fixed? (Photo)

Question

Am I missing cartilage in the left side of my nose? On the first picture I am pressing down on the right side of my nose and I can feel cartilage and everything. On the left side, I can press all the way down basically to my skull. When I broke my nose, it got worse. I recently had septorhinoplasty and I thought the doctor would fix whatever issues there were but it still looks bad. Worse actually. I want to identify the problem so I can actually get it fixed. I would appreciate any feedback.

Corey S. Maas, MD · Answer

It is great that you have taken the time to learn some anatomy however, this deformity is clearly more than just alar cartilage weakness. The ability to compress your entire tip suggests real deficiency in your nasal septum strength or even prescience (after surgery). At a minimum you will need a strong graft between the two Alar cartilages at the nasal tip and possible more. This is not difficult with an experienced facial plastic and Rhinoplasty surgeon. Ask the surgeon how many they done, now many in the last week and month and listen carefully for a logical and confident plan of action. If the only solution offered is a cartilage graft from your rib cage, try to find and qualified surgeon that does not limit your options to only this over used procedure.

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