I am 11 months post-op from Rhinoplasty. My right nostril is 'higher' than the left and it bothers me. I addressed this with my ENT/PS who reluctantly advised that we could do an alar graft (using ear cartilage) to bring the rim down a bit (and said this can be done in the office). Is this common? Is it risky? (meaning what are the chances of over-correction, leaving me with the same issue but just on the other side?)
Correcting Higher Right Nostril After Rhinoplasty?
Doctor Answers 3
An alar graft to lower the nostil 2-3mm is an excellent approach. It is minimally invasive and tecnically not difficult. Do not expect perfect symmetry. There is virtually no part of your body that is symmetrical. Obviously, I encourage you to have the revision.
Correction is possible but it could be over or under corrected.
Biology is difficult to predict with 100% accuracy.
It is likely that an improvement will be successfully achieved but you have to expect with some degree of being reasonable that overcorrection or undercorrection may be a normal result.
Did you have the asymmetry prior to surgery and became aware of it after?
It would be usefult to review your photos.
Touch up for asymmetric tip
Without seeing you in person, my answer is speculative. Most commonly, the sort of asymmetry you describe is the result of the two lower lateral cartilages resting at different levels. This is fairly common before rhinoplasty and is corrected as part of the procedure.
If this is the case, a small revisional operation can be done, usually with some sedation and local. This is called a "tip" rhinoplasty. However, you would be well advised to wait for 6 months or so after the 1st operation to let the healing compete itself. Other problems might emerge and it is possible that your problem might get better. Revisional surgery is more predictable when the inflammation from the 1st operation has subsided.
Tip grafting is an option but I would use it only if there were some deficiency in the tip cartilages.