Columella is not aligned with my mouth, uneven nostrils. Tried filler but unhappy with the results, can this be fixed? (photo)

Question

I've had surgery 19 years ago because I complained that I couldn't breath, which wasn't the real case. I didn't like how my nose looked. I was a teenager then. The ENT doctor tried to cut my nostrils to be even and sticked it up, and it was ok for then, but now I want it fixed. I got a filler recently and the pic below shows the results. But, I am just still not happy. I do not have a problem breathing. Can a doctor just somehow cut it and stitch it where is should go?

Kenneth Hughes, MD · Answer

I would have to see other photos from the front of the nose to determine if I would recommend revision.Kenneth Hughes, MDLos Angeles, CA

Andrew Pichler, MD · Answer

It appears you have a deviated columella because the caudal (terminal part) septum is off center. This would require a surgical correction. Whether the shape and size of your nostrils will turn out exactly the same cannot be guaranteed. And, cutting into the edges of the nostril is not an option,

Paul Rosenberg, MD · Answer

It is difficult to say from the photo you posted, but most likely the lower part of your septum lies slightly to the left of the midline. From this "worms eye view" it might be noticeable but from a direct frontal view it is probably minimally evident. Correction of this would require an open procedure where the deviated portion of your septum is divided from the bone of your maxilla and sutured in the midline. Once the position of the cartilage is corrected, the overlying skin should follow and once again be midline. I hope this helps!

Mark B. Constantian, MD, FACS (retired) · Answer

Based on your photograph, your nostrils actually look the same size to me, but their shape and axis is different.  If you examine your tip, your right side is lower than your left side.  This probably happened from tip surgery.   If a surgeon increases tip support on the right side, your nostril will straighten out.  I have seen this many times.Find a surgeon whom you like and who is experienced in this type of surgery.I wish you well.

Richard W. Fleming, MD (retired) · Answer

The one picture you submitted shows a deviated septum and asymmetry of your tip cartilages. Rather than fillers I would recommend a limited procedure on the nasal tip to achieve permanent correction.

Columella is not aligned with my mouth, uneven nostrils. Tried filler but unhappy with the results, can this be fixed? (photo)

Answers (5)

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