What Can Be Done to Revise Deviated Septum and Asymmetry in my Nose? (photo)

I had a nose job a year ago. Now it is deviated, assymetric, and to me a little short looking. My columella seems to be hanging, but if I mess with it, it may make my nose too short. The columella is also leaning to the right and it caused my tip to lean to the left. What could be done to fix this.. my primary surgeon suggested a stitch to bring up the columella which my help the nostril show and make the columella less droopy. But, can the deviated lower cartilages be fixed this way? Plz help!

Doctor Answers 7

Revision Rhinoplasty.

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Hello Rererider:

Because it  has been a year since your surgery, the result shown is not likely to change. 

While the profile looks pretty good, the front view does show some asymmetry, and the base view looking up also shows asymmetry. 

The photos suggest that the shift could be done due to the malposition of the septum right behind the columella. 

In a revision rhinoplasty, often straightening the septum will allow the tip to spontaneously resume a midline position and the asymmetry improves. 

Frankly, I see no other alternative other than a revision rhinoplasty. 

Robert Kotler, MD, FACS
Facial Plastic Surgeon

Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 90 reviews

A stitch won't fix, find experienced rhinoplasty surgeon!

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Hi there. Your problems can be corrected but not with a stitch- you will likely need cartilage to improve the function and appearance of your nose. You would do well to consult with two or three experienced rhinoplasty surgeons, especially those who have experience with revision rhinoplasty, as this can be a challenging procedue. Good luck!

Catherine Winslow, MD
Indianapolis Facial Plastic Surgeon
4.6 out of 5 stars 44 reviews

Revising Nasal Asymmetry and Septal Deviation

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Your tip asymmetry, septal deviation, and hanging columella can be improved by an experienced revision rhinoplasty surgeon. it will take more than a stitch.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Revision Rhinoplasty

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I would recommend that you have a consultation with a board certified specialist with a strong grasp of the underlying nasal anatomy who can address and resolve your concerns.  It is unlikely that a stitch will solve all the issues you describe.

Kimberly Lee, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

What can I do about asymmetry

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Your photos are not very clear but from what can be made out you will need more then a stitch. You either have caudal septal deviation or your tip cartilages are twisted. They also appear poorly supported and retracted. You need to consult with a surgeon with revision eperience and do some computer imaging.

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
4.8 out of 5 stars 12 reviews

Seek a second opinion and consider revision surgery

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Based upon your photos, it appears you have significant valve collapse and deviation to your septum.  Seek a second opinion from a surgeon who specializes in nasal surgery.  Warmest regards.

Dr. Pippin

Gregory Pippin, MD
Metairie Facial Plastic Surgeon

What Can Be Done to Revise Deviated Septum and Asymmetry in my Nose?

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I would suggest that you have several consults with plastic and cosmetic surgeons regarding a Revision Rhinoplasty to address these issues.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 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.