Are Post-Rhinoplasty Assymetrical Nostrils Fixable?

I had rhinoplasty around 3 months ago and what makes me so disappointed is the obvious asymmetry in my nostrils both apparent from the side views as well as the front...does it seem fixable? I can barely sleep at night because I am so worried I have to stay like this forever...

Doctor Answers 7

Yes--with composite grafts

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You have an interesting and not uncommon asymmetry: your right nostril rim is higher than your left, but your right lateral crus (the tip cartilage above the nostril) is also asymmetrical. This rotation of the cartilage usually occurs on both sides (in about 50% of the population but in 80% of secondary patients) but can be unilateral.

The treatment is to reposition the cartilage and also often add a piece of cartilage and skin from one of your ears (a "composite graft" because it is made of two different tissue types) into an incision on the inside of a nostril.  The skin added pushes the nostril rim down.  Composite grafting is very dependable.  I published a group of 100 such patients in about 2000; most had developed the problem after surgery and most had the rotated cartilage like yours.

FInd a surgeon experienced in the diagnsosis and the technique and you can be helped a great deal.

Nashua Plastic Surgeon

Uneven nostrils after nose job

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The first question I have is: were your nostrils even PRIOR to surgery. IF so, then it depends on anlayzing the cause of the asymmetry and whether it is due to soft tissue, cartilage, boney, or muscular causes. Depending on this analysis an intervention could provide you with improvments but it amy require cartilage grafting or external scars. While you will generally see an improvment, there is no guarantee for symmetry so make sure you go into this surgery with open eyes and that the asymmetry warrants the risks of the intervention.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

You appear to have nostril-columella disharmony that might require revision rhinoplasty surgery.

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I read your concern and reviewed the frontal photo you posted. I agree that  your nostrils appear different on both sides. It seems as though your lobule-columella complex is off-center and deviated to your right.

My practice philosophy is to reserve revision surgeries for a last resort, and I will often suggest Injectable Filler Treatments to lower nostrils and restore alar symmetry.

I can't be sure without viewing more photos or examining you, but my hunch is that you have a hanging columella that is also deviated to your right. This may require revision rhinoplasty to achieve correction. Feel free to email your photos (frontal and both profile views), along with a description, and i'll be happy to share my thoughts with you.

All the best from NJ.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

Post Rhinoplasty Asymmetrical Nostrils

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It is unfortunate you have asymmetrical nostrils after your rhinoplasty. However, this can be corrected with revision surgery. The one picture suggests the problem is secondary to the position of the tip cartilages or the amount of cartilage that was removed because you have retraction of the nostril margin on the right side.  You should wait another 6 months and then consult with your surgeon or a specialist in revision rhinoplasty. I've had many patients with this problem referred to me over the past 35 years.  

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Asymmetric Nostrils Post Rhinoplasty are Repairable

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The good news is that you will not have to live with asymmetric nostrils for the rest of your life.  The bad news is that you will likely require a revision rhinoplasty to make your nostrils symmetric.  But don't lose anymore sleep over it as there is nothing to do for about at least another 3 to 9 months.  Good luck and be well.

Dr. P

Encino, CA

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

Asymetric Nostrils

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If you had your nostrils narrowed and now they are asymmetric, then it will be difficult to fix the asymmetry. It is a little easier to fix asymmetric nostrils if they have not been narrowed. You may need to have supporting cartilages placed in the tip to change the orientation of your nose.

Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 285 reviews

Asymmetry of Nostrils Following Rhinoplasty

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Looking at the photo provided, your problem does seem fixable. That is the good news. Unfortunately, you are going to need to wait about 9 months before proceeding with a revision rhinoplasty procedure. Hopefully you chose a qualified rhinoplasty surgeon for your procedure and one who is capable of managing complications such as this that can arise from surgery. Good luck.

John M. Hilinski, MD
San Diego Facial Plastic Surgeon
4.7 out of 5 stars 44 reviews

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.