I Have Significant Nostril Asymmetry Post Rhinoplasty, What Can Be Done? (photo)

I'm only a few days post op but already I can tell my nostrils are significantly asymmetrical. I asked my doctor to lower my nostrils and he said he could do so by rolling the cartilage down from inside the nostril. It looks as if he did an alar reduction instead which we never discussed. I know there is still swelling and healing, but I know I'm not crazy. Can someone tell me if this is fixable. I'm very upset and don't know what to do.

Doctor Answers 5

Nostril asymmetry

It's pretty common to have asymmetric swelling initially after rhinoplasty. This normally evens out with time.

If needed a minor revision to even things out in the future can be done, but you should give your nose time to heal.

Seattle Facial Plastic Surgeon
4.9 out of 5 stars 21 reviews

Nostril Asymmetry Post Rhinoplasty

Nostril asymmetry a few days after rhinoplasty is usually secondary  to temporary swelling, cast placement, or pressure from the tape. If this does not resolve, a revision can be done. You're not crazy but  be patient don't drive yourself crazy thinking about it

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Asymmetric Nostrils Can Be Corrected

Thanks for the question. First off, don't worry... Some degree of nostril asymmetry a few days after surgery is not uncommon and it does not mean that your nostrils are going to remain asymmetric. It can be related to the presence of more swelling on one side of the nose or the other. It can also occur if the stitches used to close the incisions inside the nostrils are placed slightly closer to the nostril rim on the side that appears higher. Another confounding factor is the placement of the splint, which can push the nostril rim down. When you see your surgeon in a few days to have the splint removed, you can discuss the issue with him or her. In some cases, massage of the nostrils is advised. If the asymmetry is related to one of these issues I've mentioned, it should correct within the first several weeks after surgery. 

If the nostrils remain asymmetric after this initial period, there are often quick procedures which can be done in the office (under local anesthesia or light sedation) to correct the issue. Depending on the degree of asymmetry, this may be as simple as trimming back a bit of cartilage and/or skin inside the nostril. For cases of moderate retraction, thin cartilage grafts (rim grafts) can be placed along the inside of the nostril. In severe cases, nostril rims can be brought down with placement of composite grafts, which are comprised of skin and cartilage taken from the ear. 

The bottom line is that at this point you should try to stay positive and focus on healing. Hopefully your issue is a very short-term one, but if not, it can be corrected in a straightforward way.

Best regards,

Dr. Mehta 

Umang Mehta, MD
Bay Area Facial Plastic Surgeon
4.6 out of 5 stars 48 reviews

Nostril Asymmetry Post Rhinoplasty

A few days post surgery is still very early for you to judge the results of your surgery - be patient and follow up with your surgeon - nostril shape will often look distorted with swelling.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Nostril asymmetry several days after rhinoplasty surgery may improve as your swelling resolves.

Nostril asymmetry at this early stage may be from swelling. When you get your dressing removed, you should show this concern to your surgeon. Photos may be taken, and you can monitor your progress over the ensuing weeks.

Hope this is helpful.

Dr. Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 418 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.