Rhinoplasty to Fix Only One Side of the Nose?

Question

I have decided to have a rhinoplasty. I don't hate my nose, but my deviated tip and my right profile bother me. I have strong cartilage but very thin skin, therefore I have noticed that the cartilage from the right side of my nose tip is larger than the left one. Consequently my tip looks deviated to the right. On the other hand I have a small bump on the left side of my bridge that bizarrely can just be seen from my 3/4 right profile.
Can the right side be fixed without changing the left one? I appreciate very much the way you are sharing your knowledge. Thanks!

Farbod Esmailian, MD · Answer

It is really impossible to perform rhinoplasty on one side of the nose.  The nose is a whole unit and needs to be treated as such.  The changes that are done is a change of the whole nose and you need to be ready for that.  It does not mean that you will have a dramatic change if you dont want one, but the whole nose will be operated on.
Hope that helps.

Amy T. Bandy, DO, FACS · Answer

Sometimes subtle changes to one side of the nose can be corrected with a rhinoplasty. In your case, it is difficult to tell from your photos alone whether or not that would be the case. You may have a deviated septum, and that can only be seen by a physical exam. I would recommend having a consult with a Plastic Surgeon where you can be examined in person, and your septum can be evaluated. I would also request computer imaging of what he/she proposes to do and how that would change the look of your nose. Good luck!

Tanveer Janjua, MD · Answer

Although the problem with a nose might be only on one side it usually involves balancing the whole nose. A change in one area leads to a change in other area. In a few very select cases a small sliver of the bump can be removed without a lot of other work. However, thats not the norm.
SUMMARY: ALWAYS BE PREPARED TO UNDERGO A FULL RHINOPLASTY WHEN YOU ARE UNDERGOING A SMALL CHANGE
regards

Michael A. Persky, MD · Answer

Hi Anna Paula in Vienna (lucky you),
It appears that you are a quite lovely lady whose nose fits her face very well.  It does not distract attention away from your beautiful eyes, cheeks, and mouth.  Therefore your (revision?) rhinoplasty should be extremely subtle, and performed with precision (not that all rhinoplasty shouldn't be performed with precision).
It is difficult to appreciate the deviation of your tip without a true frontal view.  If your lower lateral nasal cartilages are asymmetrical, they can be evened, possibly by only operating on your right side.  So yes, your right side can be fixed without changing your left side.  But what about that "bump" that you can only see from left 3/4's view?  Depending upon your exam, only the left bump could be rasped down without changing the right side.
Thanks for your question and photos.
Please send a stright frontal view and let us know if you have had a primary rhinoplasty in the past.
Be well and a healthy 2010. (Hello to Vienna from me)
Dr. P

Otto Joseph Placik, MD · Answer

Even if one side of the nose is corrected, surgery is essentially performed in the same manner as a two sided correction. Are you planning on leaving the left bridge alone? Surgical improvement is possible and I would meet with qaulified surgeons to discuss your options.

Brent Moelleken, MD · Answer

You do indeed have a nasal asymmetry.  Much of it appears to be due to a deviation of the nose.  This causes the nose to appear different from each side of the face.
An experienced plastic surgeon can go over exactly what bothers you, and what is realistic to achieve.
It is certainly possible to achieve a more sculpted look. 
The differences will by nature be subtle because you already have a pretty face.

Eric M. Joseph, MD · Answer

Unfortunately, I do not see the asymmetry in the tip of your nose, or the bump on your 3/4 view in the photos you provided. You appear to have a well proportioned nose for your face. You should consult an experienced Rhinoplasty surgeon for an in-person consultation to discuss your concerns.
I hope this is helpful for you.

Richard W. Westreich, MD · Answer

There is no reason that specific issues in your nose can not be addressed.
The fact that the two sides are a little different probably results from an underlying facial asymmetry and a growth related difference in the cartilages on each side of your nose. It is not uncommon for there to be a difference in the 2 sides of the face: 1 eye or eyebrow may be a little higher or larger than the other; the mouth may be a little crooked; the jaw may be a litte asymmetric as well.
Asymmetry is quite commonly addressed in rhinoplasty. Bony asymmetries can be polished and cartilage asymmetries can be corrected with a combination of excision, grafting, and or and suture remodeling techniques.
Often, if there is an external asymmetry, a deviated septum lies underneath. Correcting this issue is typically critical in getting a nice symmetric result.
With all that, the changes you are seeking are well within the reasonable boundaries of a skilled surgeon's ability.
Best of luck!

William Portuese, MD · Answer

Yes, asymmetries of the nose are frequently addressed through typical rhinoplasty techniques. The bump only located on one side can be simply filed down. Cartilage grafts can be placed on the opposite side to match the high side of the nose. Dome suturing techniques can make the cartilages of the tip much more symmetrical when needed. It really depends on the preexisting conditions and the skill of the surgeon. Look for a surgeon who has performed thousands of rhinoplasties and is very well versed in addressing specific problems such as this.

Steven Wallach, MD · Answer

We all have asymmetry in our body. The nose is no exception. It is impossible to perform a rhinoplasty on only one side of the nose. Certainly, adjustments can be made to each side to balance the two.

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