Uneven Nostrils with Closed Rhinoplasty? (photo)

i had a closed rhinoplasty 3 1/2 weeks ago. i have my bridge worked on and narrowing of the tip. i didnt have a hump or a bump but a very slight curve, i think maybe a C shaped deformity? my nostrils from the bottom view look even but face on one seems higher than the other. i looked at old photos and it wasnt like this before. is it just uneven swelling? how much do the nostrils swell with a closed rhinoplasty. i was told that would clsoed rhinoplasty the nostrils shouldnt be affected.
update: 5-21-12
5 weeks Post Op; What are the chances that what i am seeing is my septum shifting back? and if so, is it possible it can be worse than pre op? how easy is it is to get this corrected?

Doctor Answers 13

Alar base asymmetry following rhinoplasty.

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Asymmetry of the nostrils and nasal base is possible following both an open and a closed approach to rhinoplasty.  The most common cause of this is a pre-existing asymmetry that can be accentuated by surgery.  The postop photo you have provided suggests nostril base asymmetry.  The preop photo, however, is slightly rotated and you are smiling making an apple-to-apple comparison difficult.  Hopefully, your surgeon has a standardized frontal view which can serve as a baseline for comparison once all the swelling has subsided.  At that time a revision procedure can be undertaken if you desire.

Mario J. Imola, MD, DDS, FRCSC.




Denver Facial Plastic Surgeon
4.9 out of 5 stars 124 reviews

Will a Breast Lift/Implant Eliminate the Extra Skin Below my Armpit Beside my Breasts?

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Most of the posters responses have been either prep asymmetry or swelling. So best to wait it out for 6 months before deciding if you have a real issue that needs further surgery. 

Uneven Nostrils with Closed Rhinoplasty?

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 I really suspect that the nostril size was uneven before the Rhinoplasty but in the pre-op picture the tip is under rotated and as such, you just don't notice it.  I think you have a nice result but as always feel free to ask your Rhinoplasty Surgeon about any issues you may have with your nose during the post Rhinoplasty healing phase.  

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Time & Rhinoplasty

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The recommendation of using "time" and appropriate follow-ups are good ideas.  Three & one half weeks from surgery is just the beginning.

Robert Shumway, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

Rhinoplasty and nasal asymmetry

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Hello and thank you for the question.

Nasal alar asymmetry is definitely a possibility following rhinoplasty surgery.  While I can appreciate the asymmetry of your nostrils in the post-procedural photo, the pre-procedural photo is not very revealing at the angle is not optimal.  Having said that, you are quite early from a surgical standpoint in your healing process. My recommendation would be to give your nose ample time to heal and follow-up with your plastic surgeon.


Kindest Regards,


Glenn Vallecillos, M.D., F.A.C.S.



Glenn Vallecillos, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 30 reviews

Asymmetrical Nostrils Post Closed Rhinoplasty

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Your nostril margins do look asymmetrical but this may be secondary to swelling just 3.5 weeks after your rhinoplasty. The nostrils can be affected if the lower lateral (tip) cartilages are changed regardless of whether a closed or open approach is used. At this time all you can do is be patient as swelling resolves.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Revision rhinoplasty works.

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Your left nostril does look lower and larger, but it has been less than a month since surgery.  This may look a lot better in six months.  So be optimistic.  You can always have a revision later.

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

Swelling after a rhinoplasty...

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Despite having a closed rhinoplasty, tip swelling can still be a problem.  On the other hand tip asymmetry could also be a result of a lower laterals. My best advice would be to see your surgeon.


Asymmetry of nose

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Being that you are only a few weeks out from surgery, there may very well be asymmetric swelling. Give it some time to settle down.  Goodl uck.

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

Your nostril asymmetry 3.5 weeks after Rhinoplasty Surgery may be due to swelling.

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I read your concerns and reviewed your photos:

Your right nostril margin appears a bit higher than your left. Since you're less than 1 month post-op, you should not panic and observe this for the next several months. If this does not improve on its own, you may be a candidate for a Non-Surgical Rhinoplasty treatment to lower your right nostril. My experience with nostril lowering without surgery is with Silikon-1000, an off-label filler for permanent results.

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