Nostrils Look Pinched After Rhinoplasty

Question

I had open Rhinoplasty 9 days ago and had my splint taken off today. I would really love an unbiased, professional opinion about my result.
My nostrils are asymmetrical and you can see up my nose, but I know this is is normal swelling so I'm not too worried about that yet.  What I'm really concerned about is that my nostrils seem to be pinched in. The nurse said that's just the impression from the splint, but I feel like if that was the case, it would have filled out by now.
I don't see how a nose can gain volume as it heals so I'm really worried. Is this likely to correct itself with time? Will the columella straighten out with time as well?

Daniel Reichner, MD, FACS · Answer

GG
First, let me say that 9 days is very early in the healing process and swelling can indeed distort the nose. However, I believe it is important for rhinoplasty surgeons to be honest with themselves, contain their pride and recognize problems that will not improve with time. I believe that some problems are best revised early on - a drooping tip, over-resected dorsum, over-pinched tip, marked asymmetry, crooked nose/tip will probably not improve as the swelling resolves.  
It is really hard to say from the one view exactly what you had done - I can't tell if  you had wedge nostril excisions? That being said, from this view the foot-plates (at the bottom of the columella) appear a little pinched in.  I like to see them flare out gradually, which appears more natural. Some surgeons place a suture through the foot-plates which brings them together. I also like to place thin strips of cartilage as "rim" grafts along the outside of the nostrils which help maintain a nice triangular shape and prevents "pinching" of the nasal tip over time.
More views of your nose would be helpful.  Based on the single base view, I recommend waiting 3 to 6 months to see how the swelling resolves.  Discuss these concerns with your Plastic Surgeon

Anil R. Shah, MD · Answer

Early on after a rhinoplasty it is advised to wait to see how the nose looks after the swelling subsides.

Toby Mayer, MD · Answer

It is too early to make predictions on what the nose will look like in the future. It will change and probably be to your liking. Wait at least 6 months before getting another opinion, and in the mean time, discuss your concerns with your surgeon.

William Portuese, MD · Answer

Since it has only been nine days after rhinoplasty, the nostrils are most likely pinched in the postoperative healing phase.  It really depends upon what tip surgical techniques were performed on the rhinoplasty and whether an alar plasty was performed.  Usually, the swelling and edema will resolve with time as well as any crookedness in the columella as well.

Steven Wallach, MD · Answer

Your questions are good ones. Pinching of the nostrils is not common but may have that appearance after the splint is removed. As for a crooked columella, I couldn't say much without seeing it.  In general, the splint and tape may have pushed things in funny ways, and you have to give it some time to settles down.

Nostrils Look Pinched After Rhinoplasty

Answers (5)

Answer: Depends on what surgical technique was performed

Answer: Depends on what surgical technique was performed

Answer: Rhinoplasty

Answer: Rhinoplasty

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Nostrils Look Pinched After Rhinoplasty

Answers (5)

Answer: Depends on what surgical technique was performed

Answer: Depends on what surgical technique was performed

Answer: Rhinoplasty

Answer: Rhinoplasty

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Everything you need to know about Rhinoplasty

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