Why are my nostrils flared and wide after rhinoplasty? (photo)

Question

I got a primary septorhinoplasty 7 months ago, had dorsal hump removed, deviated septum corrected, my surgeon broke my bones and when i asked he said osteotomies were preformed and no tip work done (as requested). Now when I smile my nose looks so wide and my nostrils just look huge. What happened? I am very sad with this outcome, do I need a revision?

Kevin M. Robertson, MD, FACS · Answer

The reason your nostrils flared when no tip work was done is probably because your tip was "deprojected" during your operation.  When you bring a bridge or profile down, the tip often will follow that movement, essentially projecting less.  When the tip projects less, the outside of the nostrils (alae) tend to bow outwards unless corrected at the same time.  The only other explanation would be that something was actually done to the tip, which sounds like it's not the case.Fortunately you can add an alar base reduction, which is a simple matter that can be addressed under local anesthesia in the clinic.  So bring this up with your surgeon, as he/she undoubtedly wants you happy and would likely correct this for you.

Kenneth Hughes, MD · Answer

I would give yourself a few more months for swelling to resolve.  Find a plastic surgeon with ELITE credentials who performs hundreds  
of rhinoplasties and rhinoplasty revisions each year.  Then look at the 
 plastic surgeon's website before and after photo galleries to get a   
sense of who can deliver the results. 	Kenneth Hughes, MD Los Angeles, CA

Minas Constantinides, MD · Answer

I agree with Dr. Robertson's explanation of why your nostrils may now be flaring. If your bridge was reduced, then you may have lost some tip projection, so now your tip is a bit closer to your face and the nostrils bow outwardly more. Although an alar base reduction may be successful, it may also not be the entire answer. If your tip has lost projection, then by restoring that projection your tip will look better and your nostrils will flare less. Of course, with only the photos you provide it is hard to really make an accurate diagnosis. I agree with the other surgeons that you should discuss your concerns with your surgeon and, in needed, seek a second opinion by another rhinoplasty expert. Good luck!

George C. Peck, Jr, MD · Answer

Technically speaking, the removal of cartilage can reduce the support of the nasal tip and can produce nasal flaring. In many patients the nostrils do not need any treatment during rhinoplasty.If the nasal flaring persists (high probability), it can be resolved with a small procedure. Please consult a Board Certified Plastic Surgeon with experience in Rhinoplasty.Best wishes

Why are my nostrils flared and wide after rhinoplasty? (photo)

Answers (4)

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