Nostril Asymmetry After Rhinoplasty - simple fix or revision? (Photos)

Hello and thank you for your question and pictures. I can see what you're talking about, but it's still early so it's hard to fully tell since the swelling (especially on the tip) can be asymmetric. Typically it takes up to 1-2 years for all the swelling to fully resolve, so it's too soon to tell what the final result will look like. I never use ear cartilage since it's so flimsy. If you are still unhappy with the appearance of your tip/nostrils once the swelling resolves more, you might need a revision rhinoplasty to properly correct your issue and to solidly reinforce the entire underlying framework to assure you get the BEST long term results (to prevent distortion and retraction from scarring forces over time).

Revision rhinoplasty is truly a surgery of millimeters- they are the most technically challenging procedures in all of plastic surgery! Because your nose is the DEFINING feature of your face- I would only recommend seeing a surgeon who specializes in revision rhinoplasty procedures, and who has significant training and experience performing these surgeries. I actually trained under one of the world leading revision rhinoplasty experts (who performs 1,000+ nosejobs annually).

If you are unhappy with the appearance of your nose, I recommend for you to setup a formal consultation with me (or another plastic surgeon who is extremely comfortable with revision rhinoplasties) to thoroughly discuss your surgical goals, undergo a formal examination, evaluate your options, and develop a personalized plan just for you. I hope this helps!

Dr. Donald Groves
Aesthetic Plastic Surgeon

Hello! Thank you for your question.
As far as I can see from your photos you should definitely have a revision operation in line with your surgeon's guidance. While doing research, I recommend that you pay attention to the fact that your doctor is a surgeon in the field of ent and facial plastic surgery, doing research will be useful in eliminating the question marks in your head.
Best Regards!

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

Hello and thank you for your question. Based on your photographs, you may benefit from a revision with placement of extended alar contour graft placement and nasal tip deprojection. Ear cartilage is not a good choice for this as it lacks structural integrity. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Thank you for describing your experience so clearly.
It’s important to know that nostril asymmetry is a relatively common concern after rhinoplasty, and even very subtle differences can feel quite noticeable in your daily mirror checks. However, early intervention should be approached cautiously. Revision rhinoplasty typically requires at least 12–18 months of healing time before any secondary corrections are planned. Scar maturation, swelling resolution, and tissue remodeling all continue well beyond the first year.
If your surgeon has suggested an in-office correction this early, it might be helpful to ask if there’s a specific structural issue that requires earlier intervention. If not, and your concern is purely aesthetic, patience often provides better surgical planning and more stable long-term results.
Secondary rhinoplasty procedures can be more technically challenging than primary surgeries. Once the healing period is complete, you may consider consulting with a surgeon experienced specifically in revision rhinoplasty, to ensure that any adjustments are made with long-term function and aesthetics in mind.
Wishing you clarity and comfort in your next steps.
— Güray Yeşiladalı, MD