Do I Need a Rhinoplasty for Asymmetrical Nostrils? (photo)

The cartilage to the left of my columella has been under developed since I was born. Most of my friends don’t notice. I’ve been hesitating as I’m not sure how much improvement it would give me and what if it makes it worse. I know no rhinoplasty will make it perfectly symmetrical. And it’s a highly personal choice. But I’d like to hear experts’ opinions: 1. Is rhinoplasty necessary in my case? 2. How much improvement a successful surgery will give? 3. What procedures will be conducted?

Doctor Answers 7

Nostril Asymmetry Correction

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Most Rhinoplasty operations are primarily designed for modification of hard tissue, such as cartilage and bone. Soft tissue changes are limited and often only partially successful. Since most of the nostril itself is soft tissue, it can be very difficult to predict the degree and scope of improvement.

Your asymmetry is most pronounced in the columella (the strip of skin between the nostrils). The soft tissue here is very thin and typically, the underlying cartilage asymmetry, when corrected, provides a substantial improvement in symmetry.

Your cases looks a little more complicated. Your nose even looks a little bit like a cleft lip patient's nose. These repairs are about the most difficult and complicated Rhinoplasty procedures that exist. So make sure you are really really sure the nostrils are critically important.

All the best

Manhattan Facial Plastic Surgeon
4.9 out of 5 stars 55 reviews

Asymmetrical nostrils

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One of the hardest issues to correct before or after a rhinoplasty is asymmetrical nostrils. Properly placed cartilage or combined cartilage and skin grafts can alter the height of nostril rims, but the skin often has a memory.  When viewed from below, it is very difficult to change.  Few people see you from this angle.

Stuart H. Bentkover, MD
Boston Facial Plastic Surgeon

Rhinoplasty for Asymmetry

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Nobody needs a Rhinoplasty. It is a very personal decision that should be well thought out. You do have asymmetry that can be improved greatly with Rhinoplasty surgery. A full internal and external examination would allow me to give you a complete picture of what the possibilities could be. Seek a board certified surgeon who is qualified to perform these procedures. If is something you WANT to do then go for it. 

Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 54 reviews


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No rhinoplasty is essential. You have to desire a change.  AS for your specific asymmetry, it is significant. An exam in person would be essential to evaluate what needs to be adjusted.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Rhinoplasty for asymmetry

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Rhinoplasty is not necessary unless you are concerned with the appearance of your nose, or you have problems breathing. As for the surgery, I would venture to say that cartilage needs to be added to correct the asymmetry and make the nostrils more symmetric. Your own nasal or ear cartilage could be used, if there is sufficent amount.

Best of luck,

Michel Siegel, MD
Houston Facial Plastic Surgeon
4.6 out of 5 stars 113 reviews

Asymmetric nostrils

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1. Is rhinoplasty necessary in my case?

No, you do not need a rhinoplasty. You have to want to do a rhinoplasty.

2. How much improvement a successful surgery will give?

50% or so

3. What procedures will be conducted?

Alarplasty by removing left nostril wedge and columellar lengthening on left as well.


Please keep in mind the nostril surgery to correct asymmetries is extremely difficult and highly unpredictable. If you can live with the asymmetry then don't do the surgery.


Dr. J


Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 126 reviews

Asymmetrical Nostrils

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Your asymmetry can be significantly improved by refining your tip and narrowing the base of your nose. With the pictures submitted I cannot determine if it will be necessary to change any other parts of your nose. A physical examination would be necessary before final recommendations are made.

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