What's wrong with my nose? (Photo)

Question

I noticed about 2 years ago the right side of my nose has lost volume, the actual thickness in the tissue on the right side is thinner and is collapsed. What can I do to improve symmetry? Thank you

Donald Groves, MD · Answer

Hello and thank you for your question! It sounds like your primary concern is the shape and asymmetry of your nasal tip and nostrils—one of the most common reasons people seek out both primary and revision rhinoplasty. Since you've already had a rhinoplasty, the asymmetry is likely due to a combination of residual structural irregularities and scar tissue, which can be challenging to correct. That’s why choosing an expert in rhinoplasty—especially revision rhinoplasty—is critical.

Many surgeons overlook key techniques that can soften the appearance of underlying structures in patients with thin skin, significantly improving tip symmetry and refinement. These specialized maneuvers require a high level of expertise and experience, which most surgeons simply do not have. Given your history, an open septorhinoplasty would be the best approach to precisely reshape your nasal tip, refine the bridge, and restore overall balance.

In addition to reshaping your nose aesthetically, your septal cartilage (or an alternative graft material) would be used to create structural grafts, reinforcing key areas like the columella (the strip of tissue between your nostrils). This is crucial to maintaining long-term symmetry and preventing future distortions.

Rhinoplasty is one of the most technically demanding procedures in all of plastic surgery—millimeters make all the difference. If a surgeon is only performing one or two rhinoplasties per month, they simply do not have the level of experience necessary to achieve the best possible result. Your nose defines your entire face—this is NOT a surgery to leave in the hands of just anyone.

I have had extensive training in complex rhinoplasty, working under one of the highest-volume rhinoplasty surgeons in the world (who performs 1,000+ nose surgeries per year). If you’re serious about getting the best possible result, I’d be happy to see you for a consultation (Virtual or In-Person) where we can discuss your goals, perform a detailed examination, and create a customized plan for your ideal nose.

I'm actually located right here in California. I look forward to helping you achieve the refined, balanced nose you deserve!

Dr. Donald Groves
Aesthetic Plastic Surgeon

Eric M. Joseph, MD · Answer

Based on your photos, you appear to have thin nasal skin and we can easily see the cleft in between your tip cartilages. Your thin skin is also showing that your tip cartilages are a bit asymmetrical. Sometimes this becomes more prominent with aging. Depending on your examination, microdroplet Silikon-1000 injections maybe considered for replacing lost volume and for restoring a more symmetrical nasal tip appearance. I hope this helps! Sincerely, Dr Joseph

Anna Chacon, MD, FAAD · Answer

I can suggest that you might be experiencing a condition known as nasal valve collapse. This is a condition where the nasal valve weakens or collapses inward when you inhale, making it difficult to breathe through your nose. It can be caused by several factors including aging, previous nasal surgery, or trauma to the nose.

To improve the symmetry of your nose, you might consider the following options:

1. Nasal Valve Surgery: This is a surgical procedure aimed at strengthening the nasal valve area to enhance breathing and improve the symmetry of the nose.

2. Non-surgical Rhinoplasty: This is a non-invasive procedure that makes use of fillers to improve the shape and symmetry of the nose.

3. Rhinoplasty: This is a surgical procedure that reshapes the nose. It can be used to increase or decrease the size of the nose, change the shape of the tip or the bridge, narrow the span of the nostrils, or change the angle between the nose and the upper lip.

Please consult with an ENT specialist or a plastic surgeon to discuss the best options for you. They can conduct a thorough examination of your nose and provide a more accurate diagnosis and treatment plan.

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examinations, treatment, testing, and care recommendations.

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