What’s the issue with my asymmetrical nostrils? (photos)

Question

I had my primary rhinoplasty around 6 years ago and looking to book my revision rhinoplasty sometime this year. My main issue is the asymmetry in the nostril show. I was wondering what the issue with my nostrils called so I can look up similar cases. One nostril is high and supported and circular and one is way smaller and triangular shaped . I prefer the one with the more nostril show but aiming to have an in between them both. I also want to fix the hanging collumela and narrow the wide tip.

Man Koon Suh, MD · Answer

In order to improve the appearance of your nose, it is recommended to correct the retracted ala on the left side, the hanging alar rim on the right side, the bulbous tip, and the hanging columella. It's important to note that correcting the ala rim on both sides will not necessarily make the nostrils symmetrical, but it should greatly improve any asymmetry that exists.
There are various surgical techniques that can be used to correct a retracted ala, such as an alar rim graft, lateral crural strut graft, or composite graft. The choice of technique will depend on a personal examination of the nose or an evaluation after the nose has been opened to determine the location and condition of the alar cartilages.
Hanging alar rim correction can typically be achieved by rotating the alar cartilage. Bulbous tip correction involves realigning the alar cartilage and trimming any excess cartilage or scar tissue. A hanging columella can be caused by convexity of the medial crura of the alar cartilages or hanging of the caudal septum and excess membranous septum. A surgeon will analyze the various causes to determine the best course of action to achieve the desired results. With proper analysis and correction of each issue, good results can be expected.

Eric M. Joseph, MD · Answer

Depending on your condition, microdroplet Silikon-1000 may be considered for lowering your left nostril for improved symmetry at your nasal base. You have thin nasal skin which is more prone to reveal irregularities after rhinoplasty, so please consider revision surgery as a last resort. Hope this helps! Dr Joseph

Randal Haworth, MD, FACS · Answer

Nostril asymmetry as well as hanging collumela and narrowing of the tip (tip plasty) can be performed in the hands of a well trained plastic surgeon. I’ve personally performed those revisions many times and patients have always been happy with the results.

William Portuese, MD · Answer

You have alar or attraction on your left side of your nose. This is improved with a composite graft taken from the ear.  Your nostrils will never be perfectly symmetrical. You also have a hanging columella and an overly rotated nose. Trimming back the membranous and cartilage in the columella will help with your excess columella show. Choose your second rhinoplasty surgeon wisely based on extensive experience due to the fact that this is a very difficult procedure to perform correctly

What’s the issue with my asymmetrical nostrils? (photos)

Answers (4)

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