Nose asymmetry corrected with rhinoplasty

A man with Tessier nose defect came to our hospital wanting to surgically change the shape of his nose to improve his appearance. His nostrils were asymmetrical with the left side being at a higher level than the right. The nasal septum was deviated.

Maxillofacial surgeon Dr. S.M. Balaji successfully performed the rhinoplasty to correct the alar deficiency. Deviated septum was corrected. Footplate of the medial crus on the left side was removed. Using Denonvillier’s Z-plasty technique lower lateral cartilage was brought down to reduce the columellar show on the left side. Both nostrils were made symmetrical improving the appearance of the nose and enhancing the facial profile. 

Preoperative view showing Tessier's cleft with defective ala of the nose in the left side

Preoperative view showing reduced size of the nostril in the left side with uneven alar base

Footplate of medial crus removal in the left side which reduces the columella show

Z plasty technique with Denonvillier's incision the alar level was adjusted and ala of the nose in the left side was pushed down

Immediately after suturing shows corrected alar base with symmetrical appearance of the nose

Postoperative view showing symmetrical nostrils and corrected shape of the ala of the nose