My right nostril droops. When I smile, it super droops. Is this caused by my deviated septum? (Photo)

Hello,Thanks for your question. Your deviated septum does aid in the problem. Another possible option is that the left nostril is being pulled asymmetrically, making it look like the right droops. A septoplasty and rhinoplasty could help fix all these problems. However, true asymmetry is probably not a realistic outcome. I would recommend that you consult with a rhinoplasty specialist for more information.Good luck,Dr. Shah

You are most likely correct that your septum is causing the asymmetry in your tip and the worsening when you smile, but the portion of your septum that is problematic is in the portions that have to be maintained from a simple septoplasty.  A septoplasty, may improve your breathing, but it will not help with the aesthetic problems.  You also have a deviation in your nasal dorsum to the right and a curvature of the tip back to the left.  A rhinoplasty combined with a septoplasty can improve your breathing and the aesthetics of your nose.   

Hello and thank you for your question. Based on your
photograph, you may benefit from a tip refining rhinoplasty. Your surgeon can
accomplish this by trimming, suturing, and reshaping the cartilage in your
lower nose. This can be designed to improve your nostril asymmetry.  You may also benefit from a cephalic rotation of your tip to turn
up your tip slightly and a conservative dorsal hump reduction.  Septoplasty and spreader grafts can be performed at the same time to help improve your breathing.  Make
sure you specifically look at before and after pictures of real patients
who have had this surgery performed by your surgeon and not just a computer
animation system. The most important aspect is to find a
surgeon you are comfortable with. I recommend that you seek consultation with a
qualified board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D. FACS
Harvard-trained plastic surgeon

Asymmetric nostrils can be a result of several issues including:
Deviated septum- a deviated central portion can contribute
Asymmetric facial structure- Almost every person’s face is asymmetric and imbalance can lead to difference in nostril appearance
Asymmetric nasal cartilage structure- Natural noses as well as those operated on can have asymmetry resulting in nostril asymmetry
Facial muscle imbalance- Some patients will have a dominant side that they smile or express on leading to imbalance.  Dynamic change (change which happens while expressing) is often a result of muscular imbalance.
Rhinoplasty can be used to make nostrils appear more symmetrical but it is almost impossible to make nostrils exactly the same.  Improvement and not perfection should be the goal.

Cosmetic changes or changes to the external appearance of the nose should be a consideration for everyone who has functional (septoplasty) surgery. Asymmetries in the nostrils, ala or tip can easily be addressed at the same time as your septoplasty. It comes down to a matter of cost as surgery to address the appearance are not covered by insurance. Good luck to you. 

Hello Lauren73,A septoplsty will not likely change the shape of your nose.  Looking at your photos the top of the nose (dorsum) is also deviated which is causing the asymmetry of the nostrils.  I would recommend you consult with a facial plastic surgeon to learn more about options for improving not only the breathing but also the appearance.I hope this helps and good luck.  

Thank you for the question and photos.  The nose is made up of 5 cartilages and 2  bones and all can contribute to nasal deviation.  Nostril asymmetry are more likely the result of the lower lateral cartilages as opposed to the septal cartilage.  Both the septal cartilage and the nostril cartilages can be deviated at the same time.  An in person examination would be helpful.  Ultimately, only actual surgery will allow the surgeon to see what is deviated and what needs to be repaired.  A combination of rhinoplasty and septoplasty would be helpful at that time to control everything that needs to be controlled.All the best,Dr. Remus Repta

 A hanging columella is present in the photographs it also appears to be crooked from the deviated septum itself. When the tip itself droops when smiling,  it is important to release the  depressor septi ligament which pull that tip down when animating. A rhinoplasty change the shape of the nose, while a septoplasty is only performed for breathing purposes in the back of the nose. Both procedures can be performed together under one anesthesia  with one recovery period. For many examples, please see the link and the video below