Scar tissue after rhinoplasty. Can my asymmetrical nostrils be fixed? (Photo)

Question

Ive had rhinoplasty 4 years ago and I am still unhappy with the result. I don't have the funds for a revision right now however I have heard that cortisone/steroid shots can help. I have very thick skin and I'm sure that a lot of the "swelling" on my right side comes from scar tissue. However on the left side of my nose tip I have a very hard "ball" that really sticks out of my nose. Is this scar tissue too? Also can my asymmetrical nostrils be fixed with filler?

Eric M. Joseph, MD · Answer

Based on your photos, you appear to have asymmetrical nasal tip cartilages and retraction of the nostril where the black circle is. You do not appear to have thick skin, and what you have circled on the right side appears to be a firm piece of nasal tip cartilage that is often referred to as a Bossa.

Depending on your examination, microdroplet Silikon-1000 injections may be considered for camouflaging the cartilage asymmetry in your nasal tip, and for lowering your retracted right nostril margin. I hope this helps. Sincerely, Dr Joseph

Oakley Smith, MD, FRCSC · Answer

Hi, The area you are pointing mostly is cartilage not scar, but It is better for you to consult with a facial plastic surgeon who can examine you and give you opinion based on your needs and expectations.

Lexie Wang, MD · Answer

Based on your photos, my guess is that hard ball on the left side that you circled is actually a piece of truncated lateral cartilage. ThT means it is not going to get better, it doesn't appear to be scar tissue (so it would not respond to steroid injections). You COULD get filler to try to fix the nostrils but it's a pretty risky location to inject .

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.
As far as I can see from your photos filling is definitely not safe and is a non-permanent procedure, the safest and most accurate option for you will be the revision operation. 
It would be better face to face consultation.
Best Regards!

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you are a good candidate for a revision Rhinoplasty. At 4 years post-op, this is not due to swelling but rather due to asymmetries in the lower lateral cartilages. Your nostril asymmetry can also be improved with a revision. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Ruslan Zhuravsky, DO · Answer

Hello,Unfortunately this is not scar tissue. It is a portion of your tip cartialges. They are responsible for the shape of the lower part of your nose. Your skin is not very thick. In fact, if it was thick, this would be less visible. Steroid injection will not help this and will likely make it more pronounced for this reason. The nostrils are asymmetric because the two tio cartilages of the nose are not even in shape, orientation, or location. Filler might disguise some of the irregularities, bit inky because it would thicken up the skin and make the tip more bulbous. In this case, the only place you can consider filler is above the "ball" you circled. This wpuld make it smoother and more similar to the other side but would make the nose more round and fuller. It is also not a great option because these are dangerous areas for filler, especially when injecting a nose that has been operated. I am sorry to say, but there is no great option for a quick fix in a case like this. It requires a revision by a surgeon that truely specializes in rhinoplasty and revision rhinoplasty. Review the video on nasal anatomy and this will make more sense. Good luck!

Scar tissue after rhinoplasty. Can my asymmetrical nostrils be fixed? (Photo)

Answers (6)

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