I need to know what is wrong with my nose? I had rhinoplasty done 8 months ago.

My nose is a lot better than before the rhinoplasty. I know the photos are very cropped due to the face that I don't want to show my identity. I believe I have nasal valve collapse on right nostral. They are shaped completely different. I am not sure whether or not I need my nose broken again because it's still too big? Or should I just get the nostrals fixed? Is this problem difficult to fix? I'm worried that a second operation will not fix the issue.. please be honest

Doctor Answers 3

Rhinoplasty

Dear vincor2009,

Thank you for your clinical post and photographs. Although difficult to tell without pre-operative photos as you have stated there is a significant improvement in your nasal appearance, contour and shape and nasal facial proportion. There is still some residual asymmetry particularly the alar base, the left ala being somewhat more obtuse and wider than the right alar base and there appears to be some asymmetry of the nasal dome and lower lateral cartilages. It is quite common for the nasal tip to still be bulbous at 8 months and slow resolution of nasal tip anatomy can take 12-14 months. There may be some lateral nasal side wall asymmetry and some degree of internal valve collapse.

In general, most experienced rhinoplasty surgeons will not suggest a revision surgery to the nasal tip for at least 12 months following the original procedure. At that time a careful evaluation of the pre and post-operative photographs and current clinical anesthetic concerns that you have would be warranted. Depending on your levels of expectation, the enhancement that may be required, digital imaging performed by your primary rhinoplasty surgeon can be performed in order to determine if a secondary rhinoplasty will be of help in you achieving your goals. It is very important to have realistic sense of expectation of outcome as secondary rhinoplasty can be fraught with apparel in that the results are generally not as substantive as the first procedure especially when the first procedure improved significantly the appearance of the nose.

I would revisit with your operating surgeon discussing any functional aesthetic concerns you have and then follow-up at one year to see if any enhancement surgery can improve concerns that you have at that time.

Occasionally while waiting for that 12 month point internal valve collapse, nasal side wall asymmetries and even nasal tip asymmetry can be improved with the subtle use of soft tissue injectables such as Restylane and Juvederm. I was trained in both plastic surgery and ear, nose, throat, head an neck oncology and craniofacial trauma and have been using soft tissue fillers to camouflage subtle post rhinoplasty regulators that often resolve with time with soft tissue filler aiding in the aesthetic appearance until the resolution of the asymmetry or swelling.

Additionally, occasionally the use of anti-inflammatory injectables such as Kenalog can reduce soft tissue swelling edema and hasten resolution of your overall final result.

I hope this helps and best of luck.

For more information, please review the link below.

R. Stephen Mulholland, M.D.
Certified Plastic Surgeon
Yorkville, Toronto


Toronto Plastic Surgeon
4.6 out of 5 stars 82 reviews

Nasal Asymmetry

It is important to realize that nothing is symmetrical anywhere on the body. This includes eyebrows, eyelids, ears, noses, breasts, hands, feet, etc. It is difficult to tell from the pictures just what your nose looks like and it would be helpful to compare them with your pre-operative photographs. If there are significant changes in the symmetry then I would encourage you to discuss this with your surgeon to find out what your options might be to improve the symmetry.

Rhinoplasty and nostrils

If your surgeon did not perform an alar base procedure, then in all likelihood your nostrils were asymmetric to begin with. Best of luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 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.