Uneven nostrils 1 year post tip plasty. What would be the best option for correction? (Photo)

Question

I had a "tip plasty" performed a year ago. The doctor did not touch my bridge and used septum cartilage to support my tip. I have noticed unevenness on my left nostril, and also what it looks like scar tissue (little bumps) inside my left nostril. Though I know that perfect symmetry is unrealistic, would it be possible to improve the appearance on my left nostril? I have my 1 year post op appointment soon but would like some suggestions regarding the unevenness on my nostrils. Thank you!

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you have some alar retraction of the left ala causing some asymmetry. This can likely be corrected with an extended alar contour graft during a revision. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Eric M. Joseph, MD · Answer

The base view of your nose may be difficult to correct, however, if you would be satisfied having your left nostril lowered so it is more symmetrical on front view compared to your right side, microdroplet Silikon 1000 injections may be considered. Thank you so much for your question and I hope this helps. Sincerely, Dr. Joseph

Barry M. Weintraub, MD, FACS · Answer

I am sorry you are having this problem. Notching of the nostril rim is most often caused by violating the lower-lateral cartilage on that side. It can also be caused by scar tissue and/or suture closure of the inside of the nose, which would put too much tension on the nostril rim, thereby producing a notch. The good news is this:  your situation is totally fixable with an alar-support graft. This procedure is done from the inside of the nose -- meaning it would be a "closed rhinoplasty" procedure. In my practice, I often utilize a piece of the patient's own cartilage to roll out the deficient rim lining. If you had a septoplasty, and there is a lack of septal cartilage, deantigenized cartilage is an excellent source as well.

Uneven nostrils 1 year post tip plasty. What would be the best option for correction? (Photo)

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