What type of rhinoplasty to fix how the end twists making my nostrils uneven? (Photos)

Based on your photos, you appear to have thin nasal skin with an overprojected, wide, and crooked nasal tip appearance. Since your columella veers to your left side, I suspect this is being caused by a deviation in the bottom of your nasal septum. Please consider meeting with several reputable rhinoplasty specialists who offer computer Imaging so you can see what might be best for you moving forward. I hope this helps. Sincerely, Dr Joseph

Hello and thank you for your question and the pictures. Addressing the shape of your nose (especially the nasal tip) is actually one of the most common reasons people seek out and undergo a rhinoplasty. An open septorhinoplasty can best address both your aesthetic concerns and any functional issues with your nose. I would be able to adjust the size, shape, and definition of your nose (particularly the tip)!

This truly is a surgery of millimeters- and whether you're looking for a minor adjustment or a major transformation, it requires exceptional surgical skill to achieve functional and natural-looking results! Because your nose is the DEFINING feature of your face- I would only recommend seeing a surgeon who specializes in rhinoplasty procedures, and who has significant training and experience performing these surgeries. I actually trained under one of the world leading rhinoplasty experts (who performs 1,000+ nosejobs annually).

I recommend for you to setup a formal consultation with me (or another plastic surgeon who is extremely comfortable with rhinoplasties) to thoroughly discuss your surgical goals, undergo a formal examination, evaluate your options, and develop a personalized plan just for you. I hope this helps!

Dr. Donald Groves
Aesthetic Plastic Surgeon

Based on your photos, you are a great candidate for rhinoplasty. Your tip is fairly wide and boxy and this can be narrowed to look nicer. Your septum is probably crooked at the end, and fixing it can often straighten this area out while the rhinoplasty is performed. Be sure to see a rhinoplasty expert for consultation.

Thank you for providing photographs. An open structural rhinoplasty would best address your boxy nasal tip (poor definition), nasal deviation, and wide nasal bones. In an open rhinoplasty procedure all of the cartilage structures that contribute to these deformities are directly visualized and re-contoured in order to achieve your goals. The key to a straight nose starts with a straight nasal septum so I would straighten your septum and use the extra cartilage from your septum to support the projection and rotation of your nasal tip. I hope this helps!

A rhinoplasty alone will not correct for the deformity that you have demonstrated in your photos. You will need to address the bottom portion of your nasal septum at the same time that you undergo rhinoplasty or your nose will remain twisted, or become twisted again over time no matter how well your rhinoplasty is executed.

Thank you for your question. You are an excellent candidate for rhinoplasty. I think it is one of the most beautifying surgeries that we do as plastic surgeons. A large portion of my practice is dedicated to rhinoplasty surgery. It is important to only see plastic surgeons with extensive experience in rhinoplasty, ie perform at least 6 per month and have performed hundreds of cases. Also, critically evaluate on-line galleries to see if their art form resonates with yours. Rhinoplasty is definitely a grey haired plastic surgeon's sport. Best wishes to you.

The tip of the nose is made up of two cartilages. When those cartilages are strong and broad, they make the tip look wide and they make the tip stand out. The before and after example I posted with this answer shows a nose with strong tip cartilages, like yours but more prominent. Then, when the cartilages are strong, it's more possible for them to be asymmetric, like yours, and those asymmetries show up in the different views of the nose and in the nostril shape and size. You can imagine that if the tip is small and narrow, then small asymmetries are less noticeable.



How *much* to narrow the tip, or make other changes? We figure that out with morphs, well before surgery. I'd love for you to see some excellent professionally-designed morphs of what could possibly be done with your nose. Morphs could also help you identify better just what's bothering you, and help you set a goal for the rhinoplasty that's accurate for your tastes. Profile and three-quarter views would be particularly important in morphing your nose. (Side note: in my opinion, morphs should really be done by the surgeon, or he should direct an assistant as she makes the morphs. Morphs should be made with a constant eye to what actually *can* be done in surgery, for that particular nose, and the surgeon has that information and judgment best.)

Finally, remember that rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes that your nose needs require advanced techniques, and skill that most plastic surgeons don't possess with expertise. It's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. And it also discusses how to take photos that are best for online evaluations.

I have seen this deformity often. It is usually caused at least in part by the lower edge of the septal cartilage being too long and off center. There are many ways to correct this. I usually just cut off the crooked lower part of the septum and it makes a big difference.

You would benefit from an open rhinoplasty and septoplasty. It is most likely that you septum is inclined, your tip is too wide and the cartilage is too large. The operation takes about 2 hours to perform under general anesthesia.

Best Wishes,

Gary Horndeski, M.D.

Hello,In this case the nostril asymmetry is mostly due to the tip of the nose leaning to side. The center part is the columella, it's direction is dependent on the bottom part of the septum and the lower lateral cartilages.Imagine the nose as a tent from that 4th bottom view picture. The tent has two side walls and a center post (columella). If you lean the top of the tent to one side, the opening will become uneven in the same way. This wouldn't be a specific "type" of rhinoplasty ... the specific techniques would be focused on the overall goals of what you want your nose to look like as there are several ways to correct this .. also it will depend on the the actual anatomy noted during surgery. Do several consultations with true rhinoplasty surgeons. Compare their assessments, explanations, and whether you think they have your best interests in mind. Hope that helps!Good luck!