Nostrils Two Different Sizes After Rhinoplasty

It is difficult to render a professional opinion without examining your nose or having a picture to visualize it. Based on your descriptions, there remains some degree of symmetry in your nostrils after your recent rhinoplasty surgery. I would recommend you to wait for at least one month until majority of swelling has subsided, then if there is any asymmetry talk to your rhinoplasty surgeon.  Good luck and good healing.

Dr. Kevin Sadati

It is entirely possible that the swelling you are experiencing after your rhinoplasty is normal. However, very disparate nostrils may need to be addressed although no revision surgery should be performed until approximately one year after your initial surgery if it is indeed necessary. I would discuss your concerns with your rhinoplasty surgeon.

This can be swelling which takes 6-12 months to go away. Ask your surgeon when you see him for follow up.

From what i can see your result seems good. It is very common for nose surgery patients to be over critical in the post op period. You need to wait perhaps as long a a year. Please return to your surgeon with these questions>

You do have swelling 1 month after rhinoplasty, especially if cartilage grafts were placed. You will see many changes over the next year; hopefully symmetry will improve. It is too soon to evaluate your result.

 I have performed Open and Closed Rhinoplasty for over 20 years and although the nose can be swollen for 6 months or longer, there should not be a dramatic difference between the size and position of the nostrils, IMHO.  Nostril size and orientation is determined by the size and shape of the lower crural cartilages of the nasal tip.  If these are fairly even and symmetric (no one's are perfect), then the tip and nostrils will be fairly even and symmetric as well. 

 If, on the other hand, one nostril is vertically oriented and the other is more horizontally shaped, this indicates a downward rotation (weakness) of the tip cartilage on the side with the horizontally shaped nostril.  You should discuss this with your Rhinoplasty surgeon and bring up your concerns.  One of the benefits of an Open Rhinoplasty, over a Closed Rhinoplasty is the ability to see, modify and sew the tip cartilages together to make the nostrils more symmetric and even.

Nostril asymmetries and columellar distortions are unfortunately much more common after open rhinoplasty than closed procedures because of the placement of incisions and the dissection required for exposure,  Even the best open rhinoplasty surgeons sometimes create nostril asymmetries without meaning to do so--I see them at meetings and on panels.  These asymmetries occur after closed operations but less often.  The paper I gave at the Aesthetic Society meeting last month on 100 consecutive revision patients that I  had operated on made this point.  Unfortunately not enough outcome studies have been done in rhinoplasty.

Nostril deformities are correctable. I cannot picture exactly what you are describing, but I expect that one nostril is higher than the other.  These types of asymmetries can be improved or corrected, but the tissues have to heal first.  Find a surgeon who can show you how he or she has made these corrections, and make sure that you like and trust the surgeon.

It is impossible to visualize what your concerns are.  I would strongly recommend you voice all these concerns with your surgeon.  When photos are available it is also a good idea to review your before and after photos with your surgeon.  Best wishes.