Uneven nostrils even after revision rhino - do I qualify for alarplasty at the year mark? (Photo)

Question

hi, i had a primary rhino in july 2021. my nostrils were uneven the entire time of my healing journey. i had a revision in november due to scar tissue making my nose look bulbous. i am 6 months post op rhino and my nostrils are still the same. i had a local procedure in january to try and correct the unevenness and they’re still the same. do i qualify for alarplasty at the year mark? they are truly very uneven and i absolutely hate them. i would like to know my options.

Rajan Uppal, MBBS, FRCS · Answer

This is common to some extent after rhinoplasty surgery and maybe related to swelling or some uneven healing due to scar tissue. This can be treated with non-surgical treatments before thinking about more surgery. Your surgeon should be able to give you advice on the best way forward.

Stephen J. Pincus, MD · Answer

Yes, it is definitely possible to lateralize each nostril. Since your last surgery was approximately 6 months ago and if things seem stable presently, I would think you could have a revision in the near future. The only issue would be the degree of induration & scar formation and how mobile the tissue is. My guess is that an in-person evaluation to check this last consideration would be necessary.

Eric M. Joseph, MD · Answer

Based on the photo of your nasal base, I doubt that you are a candidate for alarplasty. Alarplasty is a surgery that is used to narrow flaring nostrils. The foot plates of your medial crura appear to be flared and asymmetrical. Is being caused by a deviated septum into the right side of your nose, alarplasty would not be helpful.

Riaz Agha, MBBS, DPhil(Oxon), FRCS(Plast) · Answer

Yes I would recommend a consultation with your Plastic Surgeon in the first instance to see if they can help you with this. There is asymmetry that could be addressed through such an operation. I wish you well with your onward journey.

Jeffrey H. Spiegel, MD · Answer

At this point you are ready at any time to try to improve this. We could likely do that in the office under local anesthesia so you get the chance to comment on the outcome before it finishes.

Ronald J. Edelson, MD · Answer

It appears there are a lot of things going on at once and I doubt alarplasty is the answer. Your nostrils  and columella are thick.,are there cartilage grafts there? I would get other opinions regarding what could be done for your nose to thin it out.

Cenk Teker, MD · Answer

First of all, the termination alarplasty is not a simple procedure. It involves the resection of alar cartilages and skin. Additionally, it includes the augmentation of alar cartilages with ear, septal, or rib cartilage. Sometimes, the problem is not correctly diagnosed. Over-resection may cause contractures and scar tissue. The nostrils should not resemble keyholes; they can be similar to each other, but 100% symmetry is not the goal. They should look alike. Based on your photo, I can assume that you may also need columellarplasty.

Uneven nostrils even after revision rhino - do I qualify for alarplasty at the year mark? (Photo)

Answers (7)

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