Asymmetrical nostrils and columella. What needs to be done? (Photo)

Question

I had revision rhinoplasty a couple of years ago, but my nose is really asymetrical. I had tip reconstruction with ear cartilage, but I hate my left nostril/columella, it's definetely weird and I'd like it to be like the right one. Left picture is now and right is what I'd like it to be. My profile is fine and every doctor agrees my septum is straight and it's a matter of the tip grafts. Is it possible to fix that left side as I want? What would it need to be done? Would it be easy to do?

Mark Checcone, MD · Answer

Your question about changing nostril symmetry is a good one and somewhat complex. You alluded to one such complex variable, the columella. The other is the ala complex. Although you did a nice photoshop simulation, the result is still not completely symmetric. The tip cartilage asymmetry is contributing to the nostril differences as well, and thus is a third variable. With a complete exam of all sides of the nose, one could recommend a more specific plan for you. 
Generally speaking, better nostril appearance in a revision case can be achieved with repair of prior base reduction scars, correction of nostril size discrepancy, placement of nostril rim grafts, and/or improving the columella and infratip lobule complex. This general description may include some options that would be appropriate for you and your situation, but a more comprehensive assessment of your nose would be required before proceeding. 
I hope this helps you as you weigh your options. Best of luck with your research.

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Hi,
Yes it is possible to fix the side of your nose, you will have to undergo a revision rhinoplasty. Nostrils are naturally asymmetric; the hanging columnella can be corrected. Depending on what was performed during your revision rhinoplasty, if tip grafts were used they can be adjusted to correct the columnella. At this point it’s best to research facial plastic surgeons online and schedule consultations. It is imperative to select a surgeon who has performed many revision rhinoplasties before so you can avoid any future revisions.
Best,Dr. S

Asymmetrical nostrils and columella. What needs to be done? (Photo)

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Everything you need to know about Revision Rhinoplasty

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Asymmetrical nostrils and columella. What needs to be done? (Photo)

Answers (2)

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Recommended reading

Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.