Uneven Nostrils After 6 Weeks Post Up? (photo)

Hi Niloo,

It is best to address this concern with your rhinoplasty surgeon.  Most likely your nostrils were asymmetric prior to your surgery.  We try to point out these types of asymmetries prior to rhinoplasty as they are difficult to make perfect.  In your case, if you are not happy with the appearance of your nostrils after one year, then you may consider a revision of your nostrils.  Remember, it is very rare that noses are perfectly symmetric.  Good luck and be well.

Dr. P

Thank you for the photos!  At 6 weeks after rhinoplasty surgery it is very difficult to make any final conclusions about the appearance of your nose.  From your pictures it appears that you still have a moderate amount of swelling along the lateral nasal sidewalls, dorsum, and tip.  This excess swelling can give the appearance of nasal asymmetry.  I suggest you wait for a least 6 months after surgery to evaluate the appearance of your nose.  You must also recognize that it will take up to a year for the nose fully heal and mature to its final appearance.  Good Luck!

   An internal nasal exam would be useful to determine if you have a stitch remnant in your left nostril or something else.  Uneven nostrils are the norm in anatomy, but they can usually be improved.  This early in the rhinoplasty you should not make any judgements about the result because swelling will lessen and scar tissue will soften. 

Uneven nostrils may have been present before surgery and may be from swelling after surgery. At this point it is a wait and see thing. Give it six months or longer for swelling to subside before considering revision.

Your nostril shape is asymmetric but would need to see your pre operative shape to give you some idea if this is a post surgical change or something that will get better with time.  In general at 6 weeks you are very early in the healing process.  

Most patients have asymmetry to start and don't realize it. I always point it out. Since I have no idea what kind of surgery you had it is hard to say what you might need. It can take up to a year for things to settle. Sometimes alar rim or nostril cartilage grafts can give better symmetry. Also nostril excisions can sometimes even things up but you have to be examined to see if you are the right candidate for that.

Thanks for the images. Its common to see for the symmetry in all plastic surgery procedures more so in nose and breast without realizing that there was asymmetry to begin with. If I notice any such thing I inform my patients and tell them that I will try to correct it . Six weeks post op is too early to comment and perhaps 6 months from now you should visit your PS who should be able to fix it in case it persists. Wishing you good luck