3 years post septorhinoplasty - what can be done about uneven alars with a complete break in the cartilage? (photos)

Question

3 yrs post op primary septorhinoplasty. From the moment my cast was off i knew something was wrong, but I waited 3 yrs anyway. The front view of my nose looks very strange. Ive actually never seen anything like it before. The photos of before and after below speak for themselves. There is an actual complete "break" in the cartilage of my right alar rim. Saw my surgeon last week for rasping and he says my nose looks good and my alars are just "naturally uneven". Any advice?

Eric M. Joseph, MD · Answer

Based on your current photo, you appear to have an asymmetrical tip appearance, along with nostril asymmetry. If the lower 1/3 of your nose is what's bothering you, depending on your examination, microdroplet Silikon-1000 injections maybe considered for achieving a more symmetrical nasal tip appearance without undergoing further surgery. I hope this is helpful and thank you for your question. Sincerely, Dr Joseph

Selcuk Inanli, MD · Answer

Hello!Thank you for your question
As far as I can see from your photos Due to asymmetry, there seems to be inequality in your nose wings, a more equal image can be provided with a revision operation, although not 100%, for this I recommend revision rhinoplasty.
Best Regards!

Zoran Potparic, MD · Answer

Unfortunately, it is difficult  see so clearly what is the exact problem with your nostrils, nose base and allar cartilages. A set of good close up photos (profiles, front and base view) and, in particular, in person consultation (second opinion) whith another board certified plastic surgeon, expert in rhinoplasty, would help. Good luck.

Pawel Szychta, MD, PhD, DSc · Answer

It sounds like you're dealing with a noticeable issue in the alar rim (side of the nostril) post-rhinoplasty, which your surgeon has dismissed as "natural asymmetry." If there's a clear collapse or "break" in the cartilage, this likely needs correction. 
The best approach is to get a second opinion from a revision rhinoplasty specialist who can assess whether you need a graft*to reinforce the alar rim and fix the asymmetry. Non-surgical options like fillers may temporarily mask the issue, but surgery is often necessary for a permanent fix.

Mats Hagstrom, MD (license on probation) · Answer

It’s difficult to even tell which picture is before, and after in the pictures included. All three pictures show alar asymmetry, which was there as baseline.
Consider reposting with a complete set of proper before and after pictures.
If you don’t have a proper before, and after pictures, then ask your surgeon to forward the pictures they took.
To get a proper second opinion consultation schedule those is in person consultations with the other plastic surgeons in your community.
For second opinion consultations bring with you a complete set of proper before and after pictures and a copy of your operative report.
These are all part of your medical record that you can request from your current provider.
Best,
Mats Hagstrom MD

3 years post septorhinoplasty - what can be done about uneven alars with a complete break in the cartilage? (photos)

Answers (5)