Uneven nostrils and rounded tip. Any suggestions?

Question

I got rhinoplasty a year ago to remove bump and droopy tip. I have uneven nostrils and rounded tip. The incision line is still visible. Should I get revision? Bridge is wide too. Is this a bad nose job?

Tanveer Janjua, MD · Answer

It is very important to understand the risks of revision rhinoplasty.  I revision rhinoplasty should only be undertaken if there is a very good chance of significant improvement.  In this case the deformity is minor and shouldn't be left alone.RegardsDr. J

Pedy Ganchi, MD · Answer

Hello,It is important to examine your before photos to assess the results and to evaluate you in person to determine  whether a revision would be beneficial.All individuals have some asymmetry and this alone is not a good reason for further surgery.Your photos do not clearly demonstrate the bridge and incision line and so an in personexam is needed to determine your best options.Regards,Dr. Pedy GanchiVillage Plastic Surgery

Emmanuel Mallol Cotes, MD · Answer

Thank you very much for sharing your concerns about your Rhinoplasty with us.After having analyzed all the info and photos provided to us, i recommend to perform a Secondary Rhinoplasty (not a tip revision) this means (basically) treat the nasal bones and the nasal cartilages.Therefore i would perform a narrowing of the nasal base (nose osteotomy) and alar and triangular cartilage shaping.Respectfully,Dr. Emmanuel Mallol Cotes.-

A. Joshua Zimm, MD · Answer

The decision to undergo a revision rhinoplasty is one that should be taken with great consideration.  Minor nostril asymmetries, especially on the base view, should not be a reason to undergo a revision.  If the incision bothers you, a scar revision might be considered, but even that is "iffy."  Sometimes, there is still some minor swelling the area just above the tip, even after a year.  In those cases, a kenalog (steroid) injection can be of some help.  Speak to your surgeon about this.  Best wishes.

Thomas Trevisani, MD · Answer

Without pre-op photos and the benefit of physical exam- it's difficult to give you the best answer. Your current nostril asymmetry is not significant enough in my opinion to merit any major surgical intervention. Be aware of the fact that the human body is not a mirror image of itself and that inherent asymmetry to some degree applies to the nose.

Steven Wallach, MD · Answer

Even at one year, you may still have some swelling. It is also interesting to look at your preop photos. Many times patients do not appreciate their nostril asymmetry.

Fred J. Bressler, MD, FACS · Answer

Based on your posted images, you do not need a revision rhinoplasty and appear to have a good result. You may wish to consider a minor scar revision or dermabrasion to improve the appearance of your columella incision since it bothers you. Best wishes.

Jules Walters, MD · Answer

I do not see anything that is worthy of revision.  It would be nice to see your preop photos but it appears that you have a good result.  Best wishes.

Barry N. Silberg, MD, FACS (retired) · Answer

It is difficult to give a precise answer without seeing the before pictures.  The ability to have less rounding depends on the quality and thickness of the skin.  If the skin is pliable and relatively thin it would be possible to place a tip graft and that would give you less rounding.  This could be done using a close approach.  I would not use an open approach because it would probably produce more scarring.

Uneven nostrils and rounded tip. Any suggestions?

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