What is Wrong with my Nose? Crooked Nostrils, Costs? (photo)

As you can see, my nostrils are kinda crooked and when I smile it makes my nose look kinda ugly. In my opinion, I think I would have a really nice nose if it wasn't for that. What is causing my nostrils to be crooked? What kind of procedure can fix this? How much would it cost? The top pic is just my nose regularly without me smiling, and the bottom pic is how it looks when I'm smiling.

Doctor Answers 11

Uneven nostrils

From your pictures it appears that the lower septum is deviated to your left causing an asymmetry of the nostrils. I cannot tell if this also causes your tip to be crooked. Also need to evaluate entire septum.  Septoplasty and perhaps other procedures will probably help.

Detroit Plastic Surgeon
4.6 out of 5 stars 38 reviews

Uneven nostrils

It may be a simple issue with a straightforward solution. It appears that your nasal septum is off to your left and poking into the left nostril. If that is the case, merely removing a slice of cartilage would take care of the problem. Of course, there may be other issues which I could only diagnose with an actual exam.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 27 reviews

Uneven nostrils

It looks like your septum is deviated off to your left causing the unevenness. The cost would depend on what the rest of the septum looks like.

A septoplasty would be the name of the surgery


David A. F. Ellis, MD
Toronto Facial Plastic Surgeon
3.5 out of 5 stars 8 reviews

What is Wrong with my Nose?

         I would not advise attempted surgical correction for this degree of nostril asymmetry alone.  If there are other concerns in addition to this one, find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties and rhinoplasty revisions each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.

Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

What is Wrong with my Nose?

 Based on the photos provided, the columella is S-shaped and the anterior septal angle is deviated into the left nostril.  While this bothers you, I'm not certain this qualifies as a reason to have Rhinooplasty but that of course is your decision to make.  Most people have asymmetry of their nostrils when viewed form this base angle.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Nasal issue

It looks like your septum is displaced into the left airway at its base and this is why it looks a bit funny.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Nostril Symmetry and Smiling

Thank you for your pictures. It seems like either your septum or the bottom part of the tip cartilages (medial crura) is crooked (to the left).  In addition, the base of your nose is slightly wide; this looks even wider when you smile because the facial muscles pull on the nostrils.  The rest of your tip looks good from the base view, but other views are needed to assess completely.  A rhinoplasty can be performed to fix this, and the cost would vary depending on your location, how much work needs to be done, etc. Best of luck moving forward!

Evan Ransom, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 110 reviews

Minor asymmetry of the nose is the rule rather than the exception.

From the one provided view it looks as though the septum pushes slightly into the left airway creating asymmetry in the worms-eye view. I would not recommend correction if that is the only aesthetic problem.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 35 reviews

Asymmetric nostrils and deviated septum.

Asymmetric nostrils and deviated septum are caused by both the tip cartilages as well as the septum being crooked. I need to see better photographs of the entire nose to determine exactly what would be necessary to repair the crookedness of both nostrils and or tip. The cost will be determined by exactly what things need to be repaired in order to end up with a straight nose.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

How and When to Fix Nostril Asymmetry

The columella (the part that separates the two nostrils) is asymmetric in your case -- as it is with a significant number of people.  However, yours is minor compared to most who complain about it.  The thing to remember is that the base view you are showing us is usually in the shadow cast by the nose above and can only be seen by children and animals -- and neither of them could care less what the base of your nose looks like.  You will notice the asymmetry because you know exactly what to look for and you analyze it more than anyone else.  So I personally wouldn't worry about it too much.

Having said that, the easiest way to fix a crooked columella is to place and suture a straight cartilage strut, obtained from your nasal septum, in between the two pieces of cartilage that make up the support structure of the columella.  This can be done through either an open or closed approach.  

Richard Parfitt, MD
Madison Facial Plastic Surgeon
4.4 out of 5 stars 35 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.