Prof. Dr. Gediz Murat Serin
I am Prof. Dr. Gediz Murat Serin. Since 2006, I have performed the vast majority of both rhinoplasty and revision rhinoplasty cases in my clinic. Over time, I’ve noticed a growing trend: while patients used to focus mainly on the side or front view of the nose after surgery, the appearance of the nostrils has now become a prominent factor in aesthetic evaluations.
Especially with the rise of high-resolution photos and selfies on social media, even minor differences in the nostrils have become more noticeable.
Of course, as surgeons, we strive to make the nostrils as symmetrical and natural-looking as possible. However, as we always emphasize, perfect symmetry can never be 100% guaranteed due to human anatomy. Our goal is to achieve a natural, functional, and harmonious appearance with the face.
In this article, I explain the reasons for differences in nostril shape after rhinoplasty, the healing process, and important points to be aware of.
Why Does Rhinoplasty Affect the Nostrils?
The shape of the nostrils is determined by the nasal alae (alar structures) that surround the tip of the nose. Surgical interventions during rhinoplasty — especially tip narrowing, alar base resection, adding cartilage support, or septal corrections — directly affect these structures.
Even the slightest surgical touch in this area can make a significant difference both aesthetically and functionally. Therefore, nostrils are addressed with special care in surgical planning.
There is a common misconception about rhinoplasty in society: many patients think the nose is sculpted externally like clay and shaped into the desired form. In reality, the process is far more technical and complex.
Rhinoplasty is not a superficial aesthetic procedure, but rather a planned reconstruction of the internal structures of the nose – bones, cartilage, and soft tissue. During surgery, cartilages are reshaped, some structures are incised, and new support lines are formed using sutures. Every incision and suture has a specific tension line. The cartilage grafts we place may reshape over time based on the body’s response and, although rare, may even partially dissolve. Likewise, tissue responses during healing may lead to minor asymmetries.
In other words, we are not sculpting a statue; we are building a functional, biological, and dynamic structure. How this structure settles over time is determined not only by surgical intervention but also by the body’s natural responses.
Asymmetry in the First Weeks After Surgery Is Normal
Asymmetry observed in the nostrils during the recovery process is often temporary and expected. The main causes of differences in the early weeks include:
- Asymmetric edema (swelling): Each side of the nose does not heal identically, which may cause the nostrils to appear different temporarily.
- Suture line tension: After alar base surgery, varying tension in the stitch lines can lead to temporary asymmetry.
- Effect of splints and supports: Internal support materials may affect the angle of the nostrils.
It can take 6 to 12 months for the nose to reach its final shape. It’s important to be patient and not interpret early-stage differences as permanent.
Causes of Permanent and Noticeable Nostril Asymmetry
If noticeable differences remain after the healing period, there may be several structural causes:
- Natural facial asymmetry: No face is 100% symmetrical. Therefore, nostrils may not be exactly identical.
- Insufficient alar support: Weak cartilage support in the nasal ala may cause collapse or deformity.
- Excessive tissue removal: Overcorrection intended to improve aesthetics may have the opposite effect.
- Scar tissue (fibrosis): Post-surgical scarring may pull the nasal ala and create asymmetry.
- Septal deviation: Deviation in the nasal septum may affect the positioning and openness of the nostrils.
Aesthetic Perception and Psychological Impact
After rhinoplasty, patients tend to focus on even the smallest details of their nose, especially in high-resolution and close-up images. This may sometimes lead to negative body perception or unnecessary anxiety.
🔹 At this point, it’s important to emphasize again that we meticulously work to equalize the nostrils as much as possible, but complete symmetry can never be guaranteed due to the natural structural asymmetry of the human face. What truly matters is that the nose appears natural, aesthetic, and functional in harmony with the overall facial structure.
When Should You Consult Your Surgeon?
You should consider a follow-up appointment if the following are observed:
- Persistent asymmetry or collapse after the 6th month
- Insufficient airflow through one nostril
- Collapse or visible weakness in the nasal ala
- One nostril appearing significantly wider or narrower than the other
Such conditions can be corrected with revision rhinoplasty if necessary.
Follow-Up, Patience, and Expert Evaluation
Each individual’s healing process is different. Skin type, age, the extent of surgery, and prior interventions all affect the outcome. Therefore:
- Differences observed within the first 3–6 months are generally temporary.
- The final shape of the nose settles within 1 year.
- This process should be monitored by an expert to avoid unnecessary interventions.
Conclusion: Rhinoplasty and Nostrils Should Be Evaluated as a Whole
The symmetry of the nostrils after rhinoplasty is important for both aesthetic and functional success. However, evaluations must take into account anatomical boundaries and individual variations.
When shaping the nostrils, we as surgeons aim to ensure both aesthetic harmony and healthy breathing function. Having realistic expectations and approaching the healing process with patience are critical for patient satisfaction.
