Nostrils not even after Rhinoplasty?

Question

Dear doctors, I had a rhinoplasty recently and after my cast was removed (I'm currently 9 days post operation), I could see that one nostril is higher than the other. Left and right nostrils are not even..I do understand that this is probably cause of the swelling but would like Drs opinion as well. Thx.

Jeremy Hunt, MBBS, FRACS · Answer

The results of a rhinoplasty will be masked for the first couple of weeks due to swelling and thew sutures used at the time of surgery.The key will be time and patience and this is why surgeons say that you will not see the results of a rhinoplasty for weeks to months. Having said that it is important that you discuss your concerns with your surgeon.Jeremy Hunt

James Bonaparte, MD, MSc, FRCSC · Answer

Hi there,there are many reasons why this can happen. I typically have a long conversation with my rhinoplasty patients regarding these subtle changes that you will notice early in the healing course. Sometimes, a suture on one side is just a little tighter and as it disolves or is removed it eventually evens out. But as mentioned below, the most important thing is to find out what was done in the surgery that may have changed this and speak to your surgeon. Its very hard to answer this without a full OR report and photo's. Good luck,JB

Kenneth Hughes, MD · Answer

This is difficult to evaluate without an exam.The nose 
can be swollen for up to a year or more.  Swelling will depend upon the 
nature of maneuvers employed, presence of grafts or implants, thickness 
of skin, open vs closed, revision vs primary,  etc.	Kenneth Hughes, MD	Los Angeles, CA

Peter Callan, MBBS, FRACS, MBA · Answer

Hi there.  The commonest reason for nostril asymmetry after rhinoplasty is nostril asymmetry before surgery.  Often the symmetry has been improved, but because you are looking at your nose in a different way, the asymmetry seems now apparent whereas it wasn't before.  Check out your photos before and after with your surgeon.  If this isn't the case it may be related to post operative changes and will need to be discussed with your surgeon.  Rhinoplasty can be a bit of a give and take operation.  The aim is a cosmetic nose in harmony with your face, in harmony within itself, that functions well and is stable over time. Perfection is the aim! Slight imperfection is common, but is usually not apparent to anybody but you and your surgeon.9 days is very early.  You still have a way to go.  It may well become more even with time. All the very best.

Robert E. Zaworski, MD (retired) · Answer

It takes weeks to months for the swelling to subside.  An exam is needed to evaluate your nostrils.  There are many factors involved to determine how you are healing. Discuss your concerns with your Plastic Surgeon as he will guide you to recovery.  Best wishes!

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