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Uneven Nostrils
Uneven nostrils, also known as nostril asymmetry, can occur due to various reasons, including natural anatomy, genetics, trauma, or previous surgery. This condition is characterised by one nostril appearing larger, higher, or more prominent than the other, which can affect facial symmetry and aesthetic balance.
A caudal septal deviation refers to a condition where the lower part of the nasal septum is crooked or deviated, often causing obstruction in the nasal airway and affecting breathing. Correction methods typically involve septoplasty, where the deviated portion of the septum is straightened or repositioned to improve nasal airflow and alleviate symptoms.
When treating a septal deviation, the first step is to rebuild and correcting the asymmetries of the nostril openings. This process means either repositioning the existing septum or removing the deviated portion of the cartilage and reconstructing it with a new, straight piece of cartilage. The new cartilage is kept in place by stitches which helps to keep long lasting improvement to the nostril asymmetry.
Flared medial crura refers to the lower part of the nasal tip cartilages (medial crura) being excessively wide or protruding outward, which can contribute to a widened or bulbous appearance of the nasal tip. This condition can affect the aesthetic balance of the nose and may impact breathing in some cases.
Fix-It
Medial Crural Footplate Resection
Medial Crural Footplate Resection involves trimming or resecting a portion of the medial crura to reduce their width and bring them closer together.
Medial Crural Overlap
Medial Crural Overlap has the medial crura overlapped or folded inward to decrease their prominence and create a more tapered nasal tip shape. This technique can be effective in cases where significant reduction in width is needed.
Tip Plasty
Tip Plasty is a broader term that encompasses various surgical techniques aimed at reshaping and refining the nasal tip. Depending on the specific anatomy and goals of the patient, procedures such as cephalic trim, dome binding sutures, or lateral crural steal techniques may be used in conjunction with addressing flared medial crura. Depending on the extent of nasal asymmetry, cartilage grafts may be used to reinforce and reshape the nasal framework.
Cartilage Grafts
Cartilage Grafts like lateral crural strut grafts or shield grafts can be placed strategically to reshape and stabilise the nasal tip.
Septorhinoplasty
If the flared medial crura are associated with other nasal deformities or functional issues, a comprehensive septorhinoplasty may be performed to address both aesthetic concerns and functional aspects such as septal deviation or nasal obstruction.
Suturing Techniques
Suturing Techniques including tongue-in-groove and septocolumellar sutures can help achieve good results.
Occasionally, one nostril can become positioned higher than the other, often due to the lateral alar cartilage rotating upward on one side or as a result of previous infection or trauma that alters the soft tissue or introduces scar tissue. The severity of this issue determines the selection of corrective techniques aimed at lowering the nostril and achieving balance. These methods might involve using lateral crural strut grafts, a composite graft, or a rim graft to restore symmetry.
