One nose alar higher than the other. Is there anything that could be done? (Photo)

Question

Hi, I have one nose alar higher than the other , I could hardly feel it before rhinoplasty but now it is causing the whole tip to go to one side specially when I smile . Is there anything that could be done ? thank you.

Afshin Parhiscar, MD · Answer

Dear SaraAlar asymmetry is commonly seen post rhinoplasty when the alar bases are not symmetric to begin with. In general there are two vectors of asymmetry that are of consequence. First is vertical position differences. These can be improved with internal sutures and small wedge resections, often without creating a noticeable external scar. The other type of asymmtery, is base projection difference. In these cases, the ala start off at different height from the face. You can often see this well in a base view of the nostrils. In these cases, we often raise the side that is less projected by cartilage or other soft tissue grafts.In your case, you likely have both vertical and projection asymmetry. (Chances are, you face appears fuller on one side vs teh other)

John Layke, DO, FACS · Answer

How long ago was your rhinoplasty?  Was there an asymmetry prior to your rhinoplasty?  If there was no symmetry, than it is likely that you will need a revision rhinoplasty to correct this.  If there was a large discrepancy prior to surgery, then other maneuvers may be necessary to achieve symmetry.  Relay these concerns to your surgeon and they will formulate a plan accordingly.  Best wishes!

Brian J. Reagan, MD · Answer

Though the information is limited, I think your ala are acceptably symmetric.  Attempting to fix a good result to get a better result can lead to a worse result.   Give it more time.  Discuss the risk/rewards of a revision with your surgeon. All the Best.

Barry L. Eppley, MD, DMD · Answer

The higher ala can be repositioned down lower if desired through a simple procedure done under local anesthesia.

Shervin Naderi, MD, FACS · Answer

HiYou do not need another surgery.  This is a very subtle asymmetry which is perfectly normal and was most likely present before your original nose job because your right nostril attaches higher to the lip-cheek junction than the other side.  The two sides of the face are not perfectly symmetric.  You are most likely just paying extremely close attention to something that was always there and cannot be easily corrected so just leave it alone.  Nothing on the face is a mirror image of its other side in 85% of us.

Steven J. Smith, MD · Answer

It is difficult to say from one photo, however, many minor asymmetries can be corrected with fillers postoperatively.  Most fillers tend to last for a significant time in the nose and can be enhanced as needed in the future.  I have found fillers can be an excellent adjunct to rhinoplasty, especially in the nasal tip, dorsum and lateral alar regions.

Richard W. Fleming, MD (retired) · Answer

One nostril rim is higher and wider than the other. This may be improved but I need to see a picture of the base of your nose to definitively answer your question.

One nose alar higher than the other. Is there anything that could be done? (Photo)

Answers (7)

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