One nostril is wider than the other and it affects my smile/ frown lines. Do I Have a Deviated Septum? (photo)

Dear MissSnow,

thank you for your question and photos.  We can not determine if you septum is deviated or not because your septum is inside the nose.  A surgeon needs to look inside your nose with a speculum to determine this.  However, a septoplasty will not affect the outward appearance of the nose.  A Rhinoplasty can address these issues.  As far as one nostril being wider than the other, an exicision at the base of the nostril could be considered.

Best Wishes,

Pablo Prichard, MD

Without an intranasal examination, and from the photos you've posted, I can't say whether you have a deviated septum or not.  In terms of the nostril asymmetry you are describing, there are two possibilities.  Either the asymmetry is a result of asymmetries in the alar cartilage (nostril itself), or the asymmetry is a result of underlying bony asymmetries in your facial skeleton.  In my opinion, asymmetry in the bony skeleton is more likely given that you describe differences in your nasolabial folds (smile lines).  Most of us have natural asymmetries in our faces. Many people (myself included) have one side of the face that is flatter and broader, and one that is fuller and more narrow. from your photo, your left side looks like your broader side.  The most common place to observe this asymmetry is in the area of the cheekbones, but some people see the difference in the nasolabial fold.  In my experience, women tend to notice it in themselves more than men, because women tend to notice as they put their blush on, that one side requires a bit more than the other to achieve the same highlighting effect.  

An in-person examination of the inside of your nose, outside of your nose, and your facial skeletal structure can help determine what the right procedure for you is.  Good luck!