Nasal wings move asymmetrically - solutions? (Photo)

Question

I´m unhappy with the asymmetry of my nasal wings. As you can see on picture 1 my nasal wings are not on a "parallel line" even in a static face. It´s hard to explain but the right nasal wing is a little bit higher than the left one. It gets worse when I smile ( see picture 2). So is it possible to do something about it with relatively less surgical effort to make it more symmetrical? Or is it only a mimic issue which could only be treated by botox? (But I want a long-term result) Thanks in advance!

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your
photograph, you may benefit from a tip refining rhinoplasty. Your surgeon can
accomplish this by trimming, suturing, and reshaping the cartilage in your
lower nose. You may also benefit from an alar base reduction which can also address your alar base asymmetry.   Make sure you specifically look at before and after
pictures of real patients who have had this surgery performed by your surgeon
and not just a computer animation system. The most important
aspect is to find a surgeon you are comfortable with. I recommend that you seek
consultation with a qualified board-certified plastic surgeon who can evaluate
you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Mark K. Markarian, MD, MSPH, FACS · Answer

Hello and thank you for your question.  I can see that you have some alar (nostril) asymmetry, both static and active.  The right ala seems to sit a little higher than your left.  I would first try local anesthetic to mimic a Botox injection to see if this improves the appearance.  If unsuccessful, then a subtle rhinoplasty with alar modification can be attempted.  The next step for you is
to find the right aesthetic plastic surgeon.  In your rhinoplasty
consultation, be sure your surgeon addresses all your aesthetic goals and concerns
specifically, and discusses the surgery details including the position and size
of the incisions used (with actual photographs and not just digital animations),
the risks and benefits of the procedure, recovery time, and post-operative
course.  It may be difficult to find other noses with your specific asymmetry, but in general, be sure to see plenty of before-and-after pictures in patients who have a similar nose appearance to yours, and preferably at different time
frames (3 weeks out, 3 months out, etc) to more accurately predict your own
surgical outcome.
And lastly, I think the most
important component of the consultation is to establish a good connection with
your plastic surgeon.  It’s the connection that allows you to clearly define your desired nose outcome
goals, the first step of this whole process. If you don’t feel you have a
good connection with your plastic surgeon after your consultation, he/she may
not be the best surgeon for you.
Good luck.
Mark K Markarian, MD, MSPH
Harvard-trained Aesthetic Plastic Surgeon

Nasal wings move asymmetrically - solutions? (Photo)

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Nasal wings move asymmetrically - solutions? (Photo)

Answers (2)

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Recommended reading

Everything you need to know about Rhinoplasty

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