Can Tip Rhinoplasty Correct Asymmetrical Cartilage?

I have an asymmetrical nose, specifically the cartilage of the columella and its upper junction, and would like to have it corrected. The left side protrudes further than the right side, which causes my right nostril to appear higher than the left nostril.

I like the shape of my nose, but I would like a more symmetrical version of it. Would tip Rhinoplasty correct this problem or would the procedure cause further asymmetries?

Doctor Answers 12

Asymmetrical tip cartilages

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

A major goal of rhinoplasty is symmetry. Certainly your asymmetrical tip can be corrected and most likely without bone work. I would want to see the whole face including the profile before committing to only correcting the tip. Someone has already pointed out that a perfect nose is a rarity. It is best you accept improvement – not perfection.

Fort Myers Facial Plastic Surgeon

Tip Rhinoplasty ideal if you only need tip correction

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

If all you need is correction of the tip, then a tip rhinoplasty is ideal. This would encompass evening out and suturing the tip cartilage until they look even.

Just a couple of warnings:

1. Scar tissue and cartilage memory always conspire to reverse the surgical improvements.

2. The tip of youe nose may be the tip of the iceberg. The septum may be the twisted culprit that is causing the twist to your nose. So, find a reputable plastic surgeon to give you an honest opinion as to what you need to correct this problem.

Robert M. Freund, MD
New York Plastic Surgeon
4.8 out of 5 stars 34 reviews

Operative approach probably best for asymmetrical cartilage

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Given the one picture you show, it is possible to improve tip appearance with both fillers or surgery. In my opinion, an open approach and sutures to improve your tip will be the best way to go. However, you do need to understand that most (if not all) of us are born with asymmetries and that is a natural thing. With surgery, we can try to correct theses asymmetries as much as possible, but there is always a chance that we can create new asymmetries that bother you.

Nothing done surgically is without some risk. You need to weigh the risks and benefits and decide if that is still something you want to do. Some patients feel that a filler is less risky for that reason. In addition, a filler (like Radiesse) is not permanent and is a good way to see if that is something you like. Speak frankly with a surgeon you trust and see which solution is better for your skin and for your postoperative "risk" comfort. Good luck.

Sirish Maddali, MD
Portland Plastic Surgeon

See an experienced rhinoplasty surgeon.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

A tip plasty should solve your problem. Often this is done under local anesthesia. See an experienced rhinoplasty surgeon and he will improve your asymmetry. Surgery is the way to correct this: fillers only give temporary results and to  be repeated.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Asymmetry of the nasal tip.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

First, everyone has a bit of asymmetry in their nose as they do in all parts of their body. It can never be made perfectly symmetric. On the other hand, tip asymmetry can be improved with a tip rhinoplasty using sutures to align the cartilages better and trimming any excess cartilage that one side may have over the other. I would not recommend filler material for tip asymmetry.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

You could consider a Non-surgical Rhinoplasty to correct this assymetry.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Dear Annalynn,

If the assymetry of your nostrils is all you want fixed, consider having an injectable filler placed on the right side to lower that nostril to the same level as the left. This is an office procedure with topical anesthetic and no downtime. If this did not meet your expectations, surgery could be performed anytime.

Although this could be improved with an operation, I would always favor a non-surgical approach whenever feasible. The picture you provided may indicate that you have thin skin which is a risk-factor for developing post-rhinoplasty irregularities.

I hope this helps, and best regards.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

Goal of Rhinoplasty is Symmetry

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Although perfect symmetry is always difficult to achieve, a symmetrical nose (including the nasal tip) is certainly one of the many goals of rhinoplasty. Your lower lateral cartilages are asymmetrical in shape producing the tip appearance you dislike. During rhinoplasty, the shape of these cartilages is changed, usually using internal suture techniques. This can be done through an open or closed (endonasal) approach. There are many rhinoplasty surgeons who barely ever do closed rhinoplasties and others that use it frequently.

The rhinoplasty approach is only that, it does not predict the outcome.

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon
4.6 out of 5 stars 48 reviews

A tip rhinoplasty would help improve the asymmetry

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

 A tip rhinoplasty would help improve the asymmetry.  However, you must understand that perfect symmetry is difficult to find in nature, let alone produce it.  Direct changes to the tip cartilages via an open approach would best serve your problem.

Ricardo Izquierdo, MD
Oak Brook Plastic Surgeon

Depends on the skill of the doctor

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

A revision tip rhinoplasty should be able to correct your asymmetry. But you need to go to a skilled surgeon in doing this kind of work. This can be one of the trickiest surgeries.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.2 out of 5 stars 12 reviews

You would benefit by a tip rhinoplasty.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hi!   Looking at the one photo, in New York we would probably do a tip rhinoplasty through an open approach with internal sutures.  I think your tip can become more symmetrical.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

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.