Impaired function of transverse nasalis muscle post maxillary advancement - can this be addressed with a rhinoplasty?

Hello! Thank you for your question. What you’re describing, asymmetrical nostril movement after a Le Fort I osteotomy, is actually a known but uncommon outcome. The transverse nasalis muscle helps compress the nostrils, and during maxillary advancement, it can be partially transected or displaced. If the muscle doesn’t reattach or heal symmetrically, one side may not move normally, leading to a subtle slant or asymmetry of the alar base when smiling or pursing the lips.
In many cases, this issue can be addressed during a rhinoplasty procedure, but it requires a surgeon experienced in both nasal anatomy and functional rhinoplasty techniques. The approach may involve repositioning or reconstructing the affected alar muscles, sometimes using small grafts or precise suturing to restore symmetry, along with standard tip refinement or alar base adjustments to optimize appearance. Because this is a delicate functional concern, outcomes depend on the severity of the muscle disruption and the individual anatomy, but careful correction can often improve both function and aesthetics.
A consultation with an experienced rhinoplasty surgeon would help confirm whether these techniques are right for your anatomy and goals, but what you’re describing is something that can often be improved with precise tip reshaping and cartilage adjustement.
I hope this answers your question. Best of luck!
Justin Buro, M.D.