Surgical considerations in secondary rhinoplasty for effective correction of an asymmetric nostril.

PURPOSE Asymmetric nostrils that develop after rhinoplasty may result in nasal tip deformity and result in patient dissatisfaction. No systemic study on methods for the correction of transformed nostrils has been reported. In the current study, asymmetric nostrils were classified according to the degree of asymmetry and the authors' experiences on the correction of nostril deformities are described. METHODS Thirty-nine patients who experienced asymmetric nostrils after primary rhinoplasty were selected for the current study. Nostril asymmetry was classified as types 1 to 3. All patients underwent secondary rhinoplasty, and 3-dimensional total alar cartilage dissection and reposition were performed on most patients. Patient satisfaction was assessed using a 5-level index. RESULTS Of the 39 patients, 10 were classified as having asymmetry type 1; 13, asymmetry type 2; and 16, asymmetry type 3. The mean follow-up period after the secondary rhinoplasty was 17 months. Of the 39 patients, a total of 34 showed improvement in asymmetry after the surgery. Of the remaining 5 patients, 3 patients showed incomplete correction and 2 patients showed deteriorated asymmetry. In the patient satisfaction survey, 31 of the 39 patients answered "somewhat satisfied" or "very satisfied." CONCLUSIONS Before the correction of asymmetric nostrils that developed after primary rhinoplasty, the cause of the asymmetry should be analyzed and appropriate procedures should be selected. Three-dimensional total alar cartilage dissection and reposition are both useful methods for the correction of alar cartilage asymmetry.