Asymmetrical nostril correction after surgery?

Question

Recently my surgeon recommended refinement of surgery including graft to curve/raise right nostril, narrowing right nostril, possible lower left nostril. Breathing has greatly improved since surgery. I am just concerned that any more surgery may not improve or even worsen results. I realize that correcting nostril asymmetry is difficult. Would greatly appreciate any comments or suggestions before I make this decision. Thank you in advance.

Afshin Parhiscar, MD · Answer

Dear MimipI think the first step and perhaps the most important one, is for you to decide if your nostril asymmetry is noticeable to you. I dont think you should have surgery if you are not bothered/concerned about the asymmetry regardless of what others are concerned with.In case you are concerned and want the asymmetry corrected, I think with proper cartilage grafting and good technical skills, it is highly likely you can have improved symmetry without sacrificing your ability to breathe through your nose. I cant emphasize enough that if you choose to have surgery, make sure what you are trying to improve is "of enough concern" to you to be worth going through surgery.

Demetrio J. Aguila III, MD, FACS · Answer

Thank you for your question, as well as the photos - they help put your question into context.Revision surgery of the nose can be fraught with challenges, especially when the original procedure has achieved a good functional result.  Many patients are concerned that addressing the asymmetry in appearance can compromise the success of the previous functional procedure.The first question that you need to answer however, is whether or not you notice the asymmetry without anyone else pointing it out, and whether or not it bothers you.  If you find that it's not something that you notice, then I would suggest that you leave well enough alone - undergoing surgery to meet someone else's expectations when yours have already been met can lead to regret about any hiccups or unexpected concerns that arise in the postoperative period.If, on the other hand, you are concerned about the asymmetry, you should speak with your original surgeon about it.  You may wish to wait 6 months or more for the swelling to improve - this will make the revision procedure easier to do, and increase the likelihood that you'll have a successful outcome.  Don't be afraid to ask if the surgeon is experienced and comfortable with doing revision surgery.  Many surgeons specialize in doing the first procedure and refer patients who require revisions to other surgeons who specialize in revision surgery.  Bottom line - speak with you surgeon, and if necessary, ask for a second opinion.Best wishes.

Anthony Bared, MD, FACS · Answer

As you have said, asymmetric nostril correction is a challenging issue to address.  This being said, if you feel that your surgeon can accomplish an improvement then proceed with their recommendation.  It appears from the photos you have submitted that your columella is not in the midline (this is the part of the base of the nose that divides both nostrils).  It appears you need support in this area to help improve your nostril symmetry.

Asymmetrical nostril correction after surgery?

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