2nd Revision Rhinoplasty for Asymmetrical Nostrils - Advice?

Rihnoplasty in 2001 to correct crooked nose, but ended up causing asymmetric nostrils. 2nd in 2007 to correct something in front of nose by another MD, ended up with straight tip but did not address the nostrils uneveness, and now columella is pulling to the left, not in center, towards the left big nostrils. Now, according to a Kaiser doctor, i have deviated septum, and referred me to an Otolaryngologist Dr. Chen Theodore. due to meet him in March. Any expert advice or opinion is valuable! Thx

Doctor Answers 5

Asymmetrical nostrils after revision rhinoplasty

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Dear revision rhinoplasty patient from Los Angeles,
From limited view of your nose, it appears that the only issue I can see is deviated columella to the left causing asymmetrical nostrils. If you have nasal obstruction and it is medically necessary to have a septoplasty, then some of the septal cartilage can be used to correct the columella. Otherwise, I recommend not having another surgery just for asymmetrical nostrils.

Orange County Facial Plastic Surgeon
5.0 out of 5 stars 224 reviews

Your nostril asymmetry may or may not be due to a deviated nasal septum.

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I read your concerns and reviewed your photos. If the base view of your nose is the only view that's bothering you, you may consider avoiding further surgery. In the best scenario, since this would be your 3rd nasal surgery, achieving complete correction of your nostril asymmetry would be difficult. You should consult several experienced rhinoplasty specialists to see what could be accomplished with a third nose job.

I've attached a photo of one of my patients that had nostril asymmetry from septal deviation. In her photo you can clearly see the septal deviation that was causing her problem.

I hope this is helpful for you.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews


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Cosult more than one surgeon, You mey need the septum cartilage tocorrect problems. You may not get 100% symmetry and have to accept a slight difference.

Samir Shureih, MD
Baltimore Plastic Surgeon

Deviated nasal base

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One of the main reasons for asymmetry of the nostrils is the deviation of the lower portion of the septum.  Correction of the deviation septum and a strung columellar strut graft would be needed to improve asymmetry.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Can asymmetric nostrils be improved after prior rhinoplasty

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It may be possible to improve the columellar deviation you're noticing. If this is due to a deviation of the septum to that same side then a reconstructive septoplasty can be done to improve your symmetry.

In cases that I've done similar to yours I've found success in rebuilding the septum in that area to place it more in the midline.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
4.9 out of 5 stars 22 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.