Very Different Nostrils on Each Side 4 Weeks Post Open Septorhinoplasty

Hi I had open septorhinoplasty 17.september 2010.I had a graft done to straighten the left side of my nose (which was also taken from my nose),hump shaven and the tip was also done to shorten the nose and make it more pointy.Now my problem is with my nostrils they look very uneven one on the left is a lot bigger and higher and the other smaller and straighter also the left side where the graft was done is a lot more swollen.My bones were also broken.Is there still chance that they will even?

Doctor Answers 2

Nostril Symmetry after Rhinoplasty

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After either open or endonasal rhinoplasty, asymmetry of the nostrils can certainly take place, though it's a relatively uncommon occurrence. One cause would be the manner in which the incisions inside the nostrils are closed. If one of the dissolvable stitches is placed too close to the edge of the nostril rim,  there can be a temporary retraction or notching on this side. In this case, the asymmetry will improve with time (as the stitch dissolves and the wound relaxes) and may not require any additional intervention.

Another cause of asymmetry of the nostrils is asymmetry of the cartilage framework underneath the skin. This can most commonly be a preexisting asymmetry which was not fully corrected during surgery or can occur from weakening or overly narrowing the lower lateral cartilages of the nose. These cartilages help to maintain the height and size of the nostrils and overresection can result not only in an asymmetric appearance but also in collapse of the nostrils. 

At 4 weeks out from your surgery, you still have quite some time to go in your recovery and the issue may correct itself without the need for revision surgery. I would recommend that you follow closely with your rhinoplasty surgeon. You should wait 9-12 months before even considering revision surgery to allow the process to fully mature. This waiting period would help to ensure that as the last bit of swelling in your nose resolves, there are no other issues which need to be addressed. 

Bay Area Facial Plastic Surgeon
4.7 out of 5 stars 51 reviews

Nostril Symmetry after Open Rhinoplasty

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At this particular time you are almost a solid 9 months from your procedure.  You will continue to have a small amount of healing between now and Sept '11 but it will be somewhat minimal.  It is always worth discussing the situation with your surgeon to see if further improvement is possible.  Looking at the photo you submitted I would expect maybe a further 10% improvement in what you currently see.  If at 1 year the result is not ideal then you may want to consider further surgery to correct the shaddowing in the middle of the nose, the fullness on the left and the nostril assymetry.  This would require a second open procedure if that was something you were interested in pursuing.  Bottom line...give it a few more months and reassess with your primary surgeon.

Shepherd G. Pryor, MD
Scottsdale Facial Plastic Surgeon
4.6 out of 5 stars 23 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.