One Side of Columella Sticks out More/ Left Nostril is Smaller Than Right One Due to Columella or Septum? (photo)

Question

Protrusion of Septum? I had closed rhinoplasty 5 and a half months ago to shave down a bump and to remove a bit of cartilage from tip. I always had somewhat of a crooked bone/deviated septum but it did not show so I decided not to fix it. After surgery, nostrils looked different size since one side of the columella sticks out more in one nostril. What procedures can be done to fix this, and how minor/major is the procedure? I am curious/worried. I really do not want to have another surgery, unless it is very minor.

Toby Mayer, MD · Answer

Caudal septal deviation of the septum can be repaired with a local anesthetic and shaving this off with a minor office procedure.

John M. Hilinski, MD · Answer

Looking at the photos provided you would likely need a revisionary procedure to help move the edge of the septum more to the midline. In a good majority of cases, this can be done under local anesthesia with some oral sedation. This prominence that you are seeing is the extreme front edge of the septum (called the caudal septum), which is displaced to your left side. The goal of a revision procedure would be to mobilize this segment of cartilage and reposition it more to your right side. Hopefully this helps. Happy healing.

Richard W. Fleming, MD (retired) · Answer

The most obvious cause of your nostril asymmetry is a deviated septum which can be corrected. You also have asymmetry of the tip cartilages. It is difficult to evaluate the rest of your nose with the pictures submitted. I would need addition photographs to make additional recommendations. I'm afraid that surgery would be necessary to change the features you don't like.

One Side of Columella Sticks out More/ Left Nostril is Smaller Than Right One Due to Columella or Septum? (photo)

Answers (3)