Can Fixing my Deviated Septum Also Fix my Asymmetrical Nostrils? (photo)

Question

I have a deviated septum and I am getting it fixed later this year. My nostrils have always been slightly different sizes and I realised it is because of my deviated septum. It's not extremely noticeable but it is something I would prefer to be fixed. I was wondering if once they straighten my septum, would my nostrils look a little more symmetrical? Only the very very end of my septum is crooked. Thank you!

Brock Ridenour, MD · Answer

I assume that you have already have had a detailed intranasal examination and that you have a deviated septum.  However, the end of your septum (known as the caudal septum) is straight in your photographs and does not contribute to nostril asymmetry. Your nostril asymmetry appears to be caused by a subtle difference in the outer curvature of the nostrils and by mild asymmetry of the tip cartilages.If anything, I would consider a minor alar (nostril) modification, which will improve but not eliminate the asymmetry. Perfect symmetry is not possible.

Kenneth Hughes, MD · Answer

The caudal septum is midline, and the nostril asymmetry is not particularly marked. A septoplasty, if indicated, would not change the appearance of the nostrils. Sometimes the treatment for minor nostril asymmetry can produce a less desirable result. Kenneth Hughes, MD Los Angeles, CA

Jeremy Hunt, MBBS, FRACS · Answer

It is true that the end of the septum will create assymetry to the nostrils if it is not straight. A septoplasty will likely improve the assymetry but may not correct it fully as there may be assymetry to the other cartilages of the nose that will not be correct with septoplasty alone, and may need a rhinoplasty.  A full assessment is what is needed and then a well planned procedure by an experienced surgeon.  This way I do think you can achieve the result you are after.  All the best

	Jeremy Hunt

Steven L. Ringler, MD, FACS · Answer

Thank you for the pictures. You have a very mild asymmetry of the nostrils which is quite common. This may be caused in part from a deviated septum, and could improve after surgery. It is difficult to tell from a picture only, so you should discuss this with your surgeon. Examination of the septum would be needed to determine if straightening it would help the nostrils. Good luck.

Howard Webster, MBBS (Hons), FRACS · Answer

Hi there,

	Very asymmetric nostrils caused by a very deviated septum are almost always improved in symmetry by straightening of the septum, however are often not perfectly symmetric whne corrected. The soft tissue "memory" in the nasal rim can be strong.

	Subtle nostril asymmetry sitting on a quite symmetric nasal base view, as you exhibit, in my experience is difficult to correct and will likely persist after the septal correction.  The reason for this is that whilst septal growth and symmetry informs the basic shape and size of your nose, the subtle asymmetries of your nasal soft tissue and cartilage may be independent of the septal shape and size. I think this likely is you.

	Here's the thing though:  Whilst obvious asymmetry of the nasal base impacts on the prettiness of the nose, subtle base view asymmetry hardly does at all. It's usually not noticed and if you look at model's pictures, you'll see subtle nasal asymmetry is pretty common. 

	Patients often mistake symmetry for beauty - and they are two very diferent things.

	The advice I'd provide for you would be:  I can see it - and I don't think it impacts upon your prettiness.  I hope that the septal straightening will improve it - but it's likely it won't, as the rim asymmetry you have may not be caused by the septal deviation.

	All the best.

	Howard Webster

William Portuese, MD · Answer

A septoplasty will not change the shape of the nostrils unless there's a caudal septal deviation that is creating the asymmetry. An alar-plasty would need to be performed to make the base of the nostril is more symmetrical.

Aaron Stone, MD · Answer

A deviated septum can make the nostrils asymmetric but in your posted photos the nostril asymmetry looks like it is due more to asymmetric tip cartilage than it is due to deviated septum. I doubt septoplasty alone will correct your asymmetric nostrils. Although tip cartilage surgery can make the nostrils more symmetric perfect symmetry is not possible.
	
	I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.
	
	My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship in order to know if this assessment is valid.

Darryl J. Blinski, MD · Answer

Yes reconstructing the septum/nose could improve the nostril appearance. Best to seek IN PERSON opinions.

Steven Wallach, MD · Answer

Based on your photos your nostrils are asymmetric. Your septum is a midline structure and it looks like from the worm's eye view there is no deviation. However, your nostrils are shaped differently and likely will be after surgery as well.

Edmund Fisher, MD · Answer

The edge of the septum may protrude into a nostril making it appear asymmetric. That can also restrict breathing and is known as a caudal septum. Other causes are abnormally large medial footplate, a part of the lower lateral cartilage that is the framework of the nostril. Both these conditions are correctable with surgery.

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