Nostrils are still uneven 6 months after my closed rhinoplasty. Should I see another doctor? Do I need another surgery? (Photos)

Question

It has been officially 6 months since I've had my closed rhinoplasty. My noutrils were uneven since the day my bandages were removed (one noustril higher and other shorter). I shared my concern with my doctor but he keeps saying it's due to the closed rhinoplasty operation and how swelling occurs differently in each noustril. He tells me it will be better around year 1 but I don't see them getting even after 6 months already. Should I see another doctor? Do I need another surgery?

Eric M. Joseph, MD · Answer

I agree with your surgeon - asymmetries at the nasal base may take a full year to resolve. And if this is the only issue with your nose in the end, you appear to have a lovely result. Hope this helps. Dr Joseph

Daniel Barrett, MD · Answer

Dear Genuine850630,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Ronald J. Edelson, MD · Answer

It’s possible that the lower edge of your septal cartilage is pushing the part between the nostrils to one side. If that’s the case it’s an easy fix. Just trim that crooked cartilage away.

Tanveer Janjua, MD · Answer

It is almost impossible to achieve nostril symmetry. Any attempts can lead to taking too much off one side and then going back to take some more from the other side. As this goes on permanent scarring with poor healing can lead to worst asymmetry than before the surgery was done. 
Also, it is very important to remember that nobody will look at your nostrils from below. From the front view the nostrils don't look as asymmetric as from below. Unless the asymmetry is really obvious and disfiguring, it should be left alone. 
Regards
Dr. J

Behrad Elmiyeh, MBBS, MRCS, FRCS (ORL HNS) · Answer

Thank you for your questions and for sharing your photographs.
I can see your uneven nostrils but also see an overall aesthetically pleasing nose.
During healing period wound contracts and one can get various irregularities and asymmetries. This occurs in both closed and open rhinoplasty. Of course, one must wait for at least one year for the healing process to complete. Only then you can balance the risks of any revision surgery which is greater than the primary surgery vs it's benefits. Even though, I appreciate your concern, you must consider that none can see your uneven nostrils from front or side views.
Best wishes,

Jeffrey C. Hamm, MD - Account Suspended · Answer

Hi and welcome to our forum!
From your photos, I note that your nasal tip is well defined, the nasal dome appears symmetric, the nasion is relatively midline, but the nostril axes appear disparate. Limitations in photographic resolution do not allow me to determine if there is any nostril crease scar (from a possible nostril Weir excision). Preoperative photographs from the same angle would be extremely useful. 
Following rhinoplasty, it takes 12-18 months for the swelling and hypervascularity of healing to subside. 
During this interval, there may be some distortion of delicate structures. 
15% of cosmetic surgeries may benefit from a secondary touch up procedure. Continue follow up care with your plastic surgeon.
Best wishes...

Nostrils are still uneven 6 months after my closed rhinoplasty. Should I see another doctor? Do I need another surgery? (Photos)

Answers (6)

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