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Nostril asymmetry: comparing size, sill height, and columella

Nostril asymmetry presents in various forms, ranging from differences in perceived nostril size to disparities in nasal floor height and columellar orientation. One original post used lines on photographs to illustrate how the right nostril sill was lower than the left, while another post documented unilateral nostril pinching, columellar retraction, and surgical scarring.

When comparing these cases, distinguish between the amount of nostril show visible from the front and the shape of the nostrils viewed from below. There are also records of differences in alar rim length following previous alar reduction. The original posts explain which structural areas showed differences under the common concern of asymmetry, and what adjustments were made in each revision surgery.

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Why noses deviate and bulbous tips persist after double jaw surgery, and how rib cartilage septal reconstruction is performed — Before-and-after comparison
Before-and-after comparison

Why noses deviate and bulbous tips persist after double jaw surgery, and how rib cartilage septal reconstruction is performed

This is a case of septal damage, a deviated nasal bridge, a bulbous nose, and nasal obstruction following double jaw surgery and two prior rhinoplasties. Autologous rib cartilage septal reconstruction, cartilage repositioning, lateral osteotomy, and functional nasal surgery were performed.

Preoperative condition · Postoperative record

Why a nose becomes upturned and the columella retracts after repeated revisions, and how to reconstruct the septum — Before-and-after comparison
Before-and-after comparison

Why a nose becomes upturned and the columella retracts after repeated revisions, and how to reconstruct the septum

A case where damage from previous surgeries led to collapse of the anterior septum and nostril asymmetry. The septum was reconstructed using autologous rib cartilage, followed by nasal tip rhinoplasty with donor rib cartilage and implant replacement.

Preoperative condition · Postoperative record

Why rib cartilage reconstruction is needed when the septum is weak, even in primary rhinoplasty — Before-and-after comparison
Before-and-after comparison

Why rib cartilage reconstruction is needed when the septum is weak, even in primary rhinoplasty

A case of correcting a short, upturned nasal tip and a pinched nostril caused by congenital septal cartilage weakness. Autologous rib cartilage was used to reconstruct the septum and lower lateral cartilage, combined with lowering the nostril rim and lateral osteotomy.

Preoperative condition · Postoperative record

Why a operated nose deviates and nostrils become asymmetric after physical trauma, and how septal reconstruction is performed — Before-and-after comparison
Before-and-after comparison

Why a operated nose deviates and nostrils become asymmetric after physical trauma, and how septal reconstruction is performed

A case where post-surgical trauma caused a septal tear, resulting in a crooked nose and nostril asymmetry. Septal reconstruction was performed using autologous rib cartilage, along with realigning the columellar central axis and replacing the implant.

Preoperative condition · Postoperative record

Why the nasal tip elongates and droops years after rhinoplasty, and how to correct it — Before-and-after comparison
Before-and-after comparison

Why the nasal tip elongates and droops years after rhinoplasty, and how to correct it

A case involving a long, drooping nasal tip and nasal obstruction following previous rhinoplasty with a silicone implant and septal cartilage. The nasal tip was corrected using autologous rib cartilage, performed concurrently with septoplasty, inferior turbinate reduction, and synechia adhesiolysis.

Preoperative condition · Postoperative record

Why nasal tip skin depresses and implants show through after inflammation, and how to reconstruct it — Before-and-after comparison
Before-and-after comparison

Why nasal tip skin depresses and implants show through after inflammation, and how to reconstruct it

A case where repeated surgeries and inflammation led to depressed nasal tip skin and implant show-through. The damaged skin was revised, dermal and cartilage grafts were placed, the septum was reinforced with autologous rib cartilage, and the implant was replaced.

Postoperative record

Why a nose looks more crooked with facial asymmetry and how to correct it — Before-and-after comparison
Before-and-after comparison

Why a nose looks more crooked with facial asymmetry and how to correct it

Residual facial asymmetry and a deviated septum following double jaw surgery were corrected using autologous rib cartilage reconstruction. Lateral osteotomy, precision carving of a silicone implant, and rhinitis surgery were performed concurrently.

Postoperative record

Why the nasal tip deviates to one side after rhinoplasty and methods for reconstructing its support structure — Before-and-after comparison
Before-and-after comparison

Why the nasal tip deviates to one side after rhinoplasty and methods for reconstructing its support structure

Septal cartilage damaged from previous surgeries was reconstructed using autologous rib cartilage, and the lower lateral cartilages were restored. Lateral osteotomy and rhinitis surgery were performed concurrently to correct the crooked nose and nostril asymmetry.

Preoperative condition · Postoperative record

Why the nose looks long and the nostrils look pinched after multiple rhinoplasties — Before-and-after comparison
Before-and-after comparison

Why the nose looks long and the nostrils look pinched after multiple rhinoplasties

Lost lower lateral cartilage was reconstructed using autologous rib cartilage, and asymmetric, pinched nostrils were corrected. By lowering the radix, the appearance of a long nose was reduced, and surgery for rhinitis and nasal valve stenosis was performed concurrently.

Preoperative condition · Postoperative record

Why implants show through and nostrils look M-shaped, and how to reconstruct them — Before-and-after comparison
Before-and-after comparison

Why implants show through and nostrils look M-shaped, and how to reconstruct them

Implant show-through at the nasal tip and thinned skin were reinforced with donor dermis, and foreign substances were removed. The nasal tip was reconstructed using autologous rib cartilage, along with dragon nose correction and lateral osteotomy.

Postoperative record

Why a dorsal hump looks prominent and how to correct it along with the nasal tip — Before-and-after comparison
Before-and-after comparison

Why a dorsal hump looks prominent and how to correct it along with the nasal tip

Previously injected nasal filler was removed, the protruding dorsal hump was rasped, and lateral osteotomies were performed. The blunt nasal tip was elevated using autologous rib cartilage, and both the nasolabial angle and septum were corrected.

Postoperative record

Why nostrils become asymmetrical and the nose looks crooked, and how rib cartilage reconstruction is performed — Before-and-after comparison
Before-and-after comparison

Why nostrils become asymmetrical and the nose looks crooked, and how rib cartilage reconstruction is performed

Nostril asymmetry caused by a tilted columellar axis and loss of alar cartilage after Gore-Tex insertion was corrected through Gore-Tex removal, autologous rib cartilage alar reconstruction, and septoplasty.

Preoperative condition · Postoperative record

Why a multiply operated nose deviates and develops a widened tip, and how cartilage is reconstructed — Before-and-after comparison
Before-and-after comparison

Why a multiply operated nose deviates and develops a widened tip, and how cartilage is reconstructed

Following three prior procedures, a deviated nose caused by septal damage and a missing right lower lateral cartilage was restored through autologous rib cartilage structural reconstruction, silicone implant replacement, nasolabial angle correction, and rhinitis surgery.

Preoperative condition · Postoperative record

Why the nasal tip can remain upturned after revision rhinoplasty, and when donor rib cartilage is used — Before-and-after comparison
Before-and-after comparison

Why the nasal tip can remain upturned after revision rhinoplasty, and when donor rib cartilage is used

An upturned and deviated nose, accompanied by hesitation toward autologous rib cartilage due to past pneumothorax, was improved without implants using donor rib cartilage, recycled previous rib cartilage, nasal bone rasping, and nasolabial angle correction.

Preoperative condition · Postoperative record

Why nostril asymmetry worsens with repeated revisions, and how to correct the columella — Before-and-after comparison
Before-and-after comparison

Why nostril asymmetry worsens with repeated revisions, and how to correct the columella

After 6 previous surgeries, a drooping and tilted columella, crooked nose, and nostril asymmetry were stabilized through a closed approach using autologous rib cartilage reinforcement, lateral osteotomy, and columellar alignment correction.

Preoperative condition · Postoperative record

Why a nose operated on multiple times continues to appear upturned, and how septal reconstruction is performed — Before-and-after comparison
Before-and-after comparison

Why a nose operated on multiple times continues to appear upturned, and how septal reconstruction is performed

Following previous surgeries and double-jaw surgery, an upturned nasal tip and nostril asymmetry were precisely corrected using donor rib cartilage septal reconstruction, lower lateral cartilage restoration, and a composite dermis-fat graft to the soft triangle.

Preoperative condition · Postoperative record

Why nasal tip skin thins after multiple surgeries: autologous dermis reinforcement and reconstruction methods — Before-and-after comparison
Before-and-after comparison

Why nasal tip skin thins after multiple surgeries: autologous dermis reinforcement and reconstruction methods

We removed previous foreign materials and implants, reconstructed the nasal tip using autologous rib cartilage, reinforced the thinned skin with autologous dermis, recarved a silicone implant, and performed fat grafting between the eyebrows.

Postoperative record

Why the nasal tip turns upward and nasal obstruction occurs after multiple rhinoplasties: Autologous rib cartilage reconstruction — Before-and-after comparison
Before-and-after comparison

Why the nasal tip turns upward and nasal obstruction occurs after multiple rhinoplasties: Autologous rib cartilage reconstruction

To resolve a damaged septum, an upturned nasal tip, and rhinitis-related nasal obstruction after multiple surgeries, autologous rib cartilage septal reconstruction and inferior turbinate reduction were performed.

Preoperative condition · Postoperative record

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Common questions before reading the cases

In cases where nostril sizes appear different, is the height of the nasal sill also evaluated?

Yes, some original posts describe this directly. Dr. Kang indicated in the photos that the right nostril sill was lower, and documented using autologous rib cartilage at the lower nasal floor area while correcting the deviated structure through septal reconstruction. This case addressed not only the difference in nostril size on both sides, but also the difference in floor height.

Are there cases in this list of asymmetry occurring after alar reduction?

Yes. In the surgical record of a patient who had undergone multiple operations, it was noted that asymmetry in alar length developed after a previous alar reduction. In the same article, leftward deviation of the nasal tip and nostril asymmetry were also documented. By distinguishing between the previous reduction history and the current tip position, you can observe how these overlapping issues were addressed.

Related topics to explore

Alar retraction and pinchingWide alae and nasal sillRetracted columella and short columellaAlar and nasal sill reduction

Surgical records referenced in this guide

  • Methods for correcting nasal deformities associated with cleft lip and palate
  • How to correct nasal obstruction and a wide, spread-out nose
  • How to correct a crooked nose and nostril asymmetry together
Original article

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