Could a Septoplasty Cause my Once (Mostly) Symmetric Nostrils to Become Uneven?

It looks like your nostrils are a bit uneven with the left smaller than the right.  Typically, the problem stems either from the end of the septum being offline from the midline or the footplate of the lower lateral cartilage flaring out into the airway.  It is a bit tough to tell which (or both) are the problem with you.  If it is just the footplate, an in-office procedure with a long-lasting (or permanent) suture might do the trick.  I would ask your surgeon about it.  Good luck!

 

Colin Pero, MD
 

Yes, it is possible for a septoplasty to created some asymmetry in the nostril openings.  Although the nostril rims are not touched during this procedure, the septum itself can shift position and can push againsts some the cartilage that makes up the tip of the nose.  This can in turn cause the structure which divides the two nostrils (called the columella) to project more into one nostril than the other.  This can be easily corrected with a minor procedure.

A right handed surgeon would peform the surgery through the left side of the nose and the incision on that side can commonly create some swelling and edema at the level of the columella and medial crura on that side (partition between the nose).  If this persists beyond 1 year and you truly had perfectly symmetric nostrils then a small revisional procedure can correct that.  From the photo you submitted the nostril rims themseleves are symmetric...so it is truly the medial portion of the left nostril that is slightly too full giving the appearance of assymetry.

It is possible to have asymmetry of the nostrils if a septoplasty was performed that involved the most outward portion of the septum.  This is rarely done. 

It is possible but you will have to compare before and after photos to be sure.  Most often, patients have uneven nostrils to begin with but did not pay as much attention to nostril symmetry before the surgery. Also, it looks as though the lower portion of the left tip cartilage is more flarred than the right and this has caused your nostril to look asymmetric.