Uneven nostrils 2 years after nose surgery.

My nose was crooked and the tip bulbous. I had surgery 2 years ago and it is straighter and though less bulbous, the tip is not as refined as I had expected, it is rounded. But what bothers me most is that my nostrils are bigger than before and are not the same size. I am now told that this is not uncommon. Why is it difficult to get the nostrils the same ? Does the surgeon see that they don't match in the OR? Is there a procedure to make them match or best to leave well enough to alone ?

Doctor Answers 4


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If the nostrils were not touched in terms or alarplasty during the first surgery, then it is likely that you did not notice the asymmetry preop. Best to review those photos as well.  An alarplasty may be able to better match the two nostrils.

New York Plastic Surgeon
4.2 out of 5 stars 30 reviews


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Thank you for your question.I am sorry to hear that you are not completely satisfied with your results. Rhinoplasty is an extremely precise and complicated procedure and it is almost impossible to get perfect symmetry. The nose can change over time and nasal bones may shift etc. I would recommend scheduling a consultation with your doctor or another board certified plastic surgeon to have an alarplasty performed which is a technique that is commonly used for nostril reduction. This procedure consists of making an incision on the inside or outside of the nostrils then removing a specific amount of tissue. I hope this helps.
Best of luck in your endeavors!
Sincerely, James Fernau, MD, FACS
Board Certified ENT
Board Certified Plastic Surgery
Member of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS, International Federation for Adipose Therapeutics & Science

James Fernau, MD, FACS
Pittsburgh Plastic Surgeon
4.9 out of 5 stars 86 reviews

2 years post rhinoplasty

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Thank you for your question.  Rhinoplasty results evolve over time.  At two years, I would expect this is the end result for you.  Get a copy of your operative report and any surgical diagrams to share with an experienced Board Certified rhinoplasty surgeon.  Of course changes can be made at this point but it is nice to see what has been done before making any recommendations. Best of luck!

Michael Sullivan, MD
Columbus Facial Plastic Surgeon
4.9 out of 5 stars 112 reviews

Uneven nostrils

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It's hard to make a specific comment without photos and an in person exam, but in general, rhinoplasty is one of the most difficult operations in plastic surgery. Some key things would be to recognize asymmetry of the nostrils prior to doing the surgery and formulate a plan to address it if necessary. Sometimes smaller differences can be difficult to judge as well due to swelling during the surgery. Moreover, some surgeons may remove too much cartilage from the nose trying to narrow a bulbous tip, causing the tip to lose support and the nostrils to seem larger. Lastly, the final result depends on how you healed, which can also vary by the patient. Seek consultation from a board certified plastic surgeon so that you can decide together what can be achieved and whether or not it is worthwhile for you to pursue revision surgery.

Jeremy B. White, MD
Miami Plastic Surgeon

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.