Why is there cartilage popping out of both sides of septum wall, visible through nostril? (photo)

Question

Primary rhinoplasty done in the past & recently noticed the cartridge walls popping out on both sides of the nasal wall, very prominent on one side more than the other. Head must be tilted upward for a clear view. What is this? Is it common after a primary rhinoplasty? Is it caused from occasional tweezing nose hairs, could the sutures have been pulled apart, I started plucking 1-2 years after rhinoplasty and its occasional just visible hairs. How is this fixed? Price range, possibly in NY?

Prashant Soni, MD · Answer

A physical exam is necessary to define precisely what is the problem. However it appears that the lowest part of your septum is not lined up in the midline and has slipped sideways into the nostril a bit. This can be fixed, but it may require revising your rhinoplasty. In my experience, altering this part of the septum often shifts the tip cartilages as well. If the issue you describe is not causing any breathing issues or cosmetic concerns, you may just want to leave things alone .
Best regards, Prashant Soni M.D.

Steven Wallach, MD · Answer

It might represent the foot plates of the nasal tip cartilages or it can be deviation of the septum . A full exam in person is helpful.

Armand V. Simone, MD · Answer

It looks to be the inferior [lower] part of your septum that is protruding into your nostril.  It is important to know if any septal work was done at the time of rhinoplasty ...  It is not due to hair plucking unless chronic inflammation from continuous plucking caused scarring  which distorted the cartilage underneath.  The septal cartilage is corrected by either surgically placing it into the midline continuing its role of support if needed or alternatively, removing that which is protruding  if it is serving no purpose.  If it is a simple correction, you're looking at $4-5,000.  If more involved upwards of 8-9,000.  Insurance may possibly cover some of the expense if there is obstruction or functional compromise. Good Luck
Armand Simone, MD  NewYork, NY

David L. Cangello, MD, FACS · Answer

Hello and thank you for your question.The issue you have is that the caudal part of the septum is deviated to the left. There are 2 cartilages called lower lateral cartilages and the footplates of those cartilages are attached to the caudal septum. When the septum is deviated to one direction it causes the footplate to be pushed out into the nostril with it. This can be corrected by fixing the deviated septum and sometimes suturing (although not always necessary) the medial footplates. Hope this helps.

Benjamin W. Cilento, MD · Answer

HI,
  It seems like you are describing an asymmetry of the footplates of your medial crura. It is normal anatomy but may be more prominent due to a malposition of your caudal septum which sits just behind this structure. It is not from sutures or tweezing... it is due to post operative changes. The good news is that it can be fixed relatively easily...it is the cost of a revision rhinoplasty... not sure in new York but here in Houston it is 6,000-8500.... good luck

Dr Ben

Why is there cartilage popping out of both sides of septum wall, visible through nostril? (photo)

Answers (5)