It would be possible to lower the nostril with a scar release and local rotation flap from the radix. It really depends on cartilage status and how much soft tissue is needed after a the scar is release. It would be unlikely to need a skin graft in that area as there are many local reconstructive options.
Rebbeca- thanks for your question. The short answer is that "Yes, your nostril and alar asymmetry can be improved". There are several factors that have likely occurred due to your hemangioma and subsequent grafting. There are a number of rhinoplasty techniques that can be used to address these. In order to truly provide the options best for you, and discuss their risks and benefits, your best option is to schedule a consultation with a board certified rhinoplastic surgeon who is experienced in reconstructive, functional, and aesthetic rhinoplasty. I would be happy to see you!
A graft of skin and cartilage from the ear (composite graft) will lower the retracted nostril.The graft is placed inside the nose. But to make is exactly symmetrical, is possible, but not 100% guaranteed.
Thank you for your photo and question.
You have a complex problem with the nostril asymmetry. The skin graft that was put because of the hemangioma did not grow at the same rate as the rest of the skin of the nose, so the right side ended up being contracted and pulling on the nostril.
The symmetry of the nostrils can be improved. It is hard to make them match perfectly, but you can certainly improve it.
To give you an idea of things that can be done, in my hands I would likely recommend a composite graft meaning a piece of cartilage from the ear that also comes with skin so that I can expand the nostril on the right side and bring it down.
I would recommend you consult an experienced rhinoplasty surgeon.
The short answer is yes. I use an alar contour graft which is cartilage placed along the rim of the right nostril. You should get marked improvement. Perfect is hard to achieve.
It's likely that the nostril can be lowered to a point that you will be less asymmetric. Getting perfect symmetry with the other side, although possible, is not extremely likely. The success of the rhinoplasty depends in part on how much scarring is present from the skin grafting done 20 years ago. I would make an appointment with a cosmetic surgeon experienced in both rhinoplasty and revision rhinoplasty for an in person evaluation. As with all cosmetic procedures, your expectations of the results are critical. If you need to be completely symmetric in order to be happy, I would be very careful proceeding with surgery. If an improvement in the asymmetry would make you happy, then I do think an experienced rhinoplasty surgeon could be successful. Good luck.
nostril asymmetry is the most difficult area of asymmetry to correct, in most
cases it can be improved during rhinoplasty. While perfect symmetry is
not attainable, improved symmetry usually is.
Thank you very much for sharing your concerns with us.
The harmony between facial parts makes us instinctively recognize the beauty... without knowing it, without defining it, just a perception that surprises and captivates us.
In this regard, I suggest perform a Closed Rhinoplasty (without visible scars) to treat the tip, base and nasal bridge.
With this procedure you get a delicate nose, better harmonize with your other facial features.
Dr. Emmanuel Mallol Cotes.-