Asymmetrical nostrils after open rhinoplasty/septoplasty (photos)

These are pictures of what my nostrils looked like prior to surgery. My doctor said he decided to make my nostrils more symmetrical. I don't see it. Can it just be really swollen on the left nostril. I only ask this because this is the nostril that he worked on.

Doctor Answers 6

Tip cartilages have internal stress and can deform after sugery

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What I see is not uneven nostrils but an uneven tip.  Before surgery your tip cartilages ran along an axis toward the inner corners of your eyes--this is a normal anatomical variation present in about half the population.  If any tip cartilages are reduced, the narrowed cartilages may not be able to keep their shape--the internal stresses are disturbed--and so your right side has bowed and become more rounded than your left.  The position of your cartilages determines the location of the bulge on the right.  You are also wide compared to your preoperative shape, but much of what Is seen at a month is certainly swelling.

You may or may not need a revision.  Make sure that your surgeon--whoever it is--understands your anatomical variation and can correct it for you.  In all likelihood, the result will improve with time, but some asymmetry may remain.  I wish you the best.

Nashua Plastic Surgeon

Nostril Asymmetry after surgery

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Dear Serendipity, It is early in the recovery phase to make any absolute determinations. The photographs needed are a caudal view so that you can see the nostrils from the the lip view prior to surgery and the same after. Secondly when your surgeon stated "He decided to fix the asymmetry?"  What procedure was done for this? Did he perform an alar reduction on one side or was it lower cartilage manipulation that caused this? While I certainly see your cause for concern I would give this some time and  speak with your surgeon, discuss your concerns and then see where this leads you down the road. Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 218 reviews

Lower lateral cartilages

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It seems the manipulation of the lower cartilages in surgery may have lead to this asymmetry.  It may be necessary to revise the surgery.  Swelling alone should not lead to such pronounced asymmetries.

Asymmetric nostrils after open rhinoplasty.

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Asymmetric nostrils after open rhinoplasty. Six weeks is too soon to make any judgment about your nostril asymmetry. Wait at least 6 to 12 months before any further surgery.   

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Tip asymmetry issues

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Without seeing more views like from below( worm's eye) it is difficult to say.  But, since you just had surgery you are more than likely swollen. Be patient.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Tip asymmetry

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Even without knowing exactly what was done at your surgery, I can tell you that it is VERY early to evaluate results after your open rhinoplasty. If indeed tip asymmetry persists throught the recovery/healing process (usually 12-18 months after open), it is most commonly because of asymmetry of the tip cartilages and sometimes because a deflection of the lower septum alters the position of those same cartilages.
Your surgeon will likely be watching this over time and making any recommendation--if needed-- down the road.

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.