I received rhinoplasty ten years ago and one nostril came out bigger than the other. Help? Suggestions? (Photo)

Ive seen my plastic surgeon and they said to try a shot of kenalog (up to two shots) and if this doesn't work I will need to get surgery again. Another plastic surgeon said they could fix my nostril without putting me under, which reduces the cost for me. Ive also been told I can get botox or injections in my nose to fix the size but Ive read there are more risks with these injections. Don't know what would be the safest option and least risk of making my nose worse.

Doctor Answers 7

Revision rhinoplasty

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The correct answer and treatment for your problem is revision tip rhinoplasty. Although surgery seems like a lot to undergo to correct this problem, it is the right answer for you.  Non surgical options will not address the cause of the problem, which is the position and size of the cartilage underneath the skin that makes up the tip of your nose. Start researching plastic surgeons that specialize in revision rhinoplasty and save the time you have spent looking at nonsurgical options.

Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 44 reviews

Cartilage Asymmetry Post Rhinoplasty

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Dear sophiamort, You should not be considering any of the methods stated above to help with your current concerns. You need a revision rhinoplasty to address the asymmetry of your tip cartilages which is the cause of the nostril asymmetry. See an expert rhinoplasty surgeon to discuss in detail the techniques which will be used to correct this. Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 218 reviews

Nostril Asymmetry

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Stop!!! Please do not get cortisone, Botox, or filler injections. Your nostril asymmetry is very clearly (thanks to your photos) due to tip cartilage asymmetry, not swelling, muscle pulling, or lack of soft tissue. Any of these non-surgical options will be insufficient or worse. Similarly, a 'simple' surgical procedure like a rim graft would not address the other aspects of the asymmetry that exist, and frequently doesn't adequately fix the higher alar arch/larger nostril. You would best be served by an open tip revision to reposition the offending side's tip cartilage into a lower position, which would address all asymmetries in an anatomic way. If your surgeon is not a revisions rhinoplasty specialist, go visit a few that are. Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 100 reviews

Nostril Asymmetry after Rhinoplasty

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There will be no harm in trying the Kenalog injections I doubt this will make any significant difference. While perfect symmetry is not a goal I suggest you consider a revision of your tip to reduce the asymmetry of your wide tip and lift the hanging columella (the strip between your nostrils).

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Revision rhinoplasty for nostril asymmetry.

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Revision rhinoplasty for nostril asymmetry is what will fix this-not Botox or Kenalog. This can be done by a very experienced revision rhinoplasty surgeon under local anesthesia,

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews


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Thank you for the question and the photo but an examination is really needed.  So go on some more complimentary consultations and get some opinions and be sure to bring preop photos and your operative note.

Dr. Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 65 reviews

Nostril Symmetry Concerns After Rhinoplasty

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It's challenging to pursue options for perfect symmetry of nostrils after previous rhinoplasty, but in my view, based on posted photos,  I do not see the benefit to kenalog or botox injections to your nose. I believe the safest option would be to consider revision surgery. 

Fred J. Bressler, MD, FACS
Houston Facial Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.