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Steven M. Denenberg, M.D.
Dr. Denenberg's articles on Medium.com.
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The bones and cartilage in the nose don't actually grow with time, but the cartilages that form the tip of the nose release their grip on the upper regions of the nose and pull down and away with gravity.  That movement lowers the position of the tip, making the nose look longer, and thus bigger.  Changes in the skin can also make a nose appear bigger.

She also had a mild convexity of a hump along the dorsum of her nose.

You can see that the jowl, the droop of skin between her ear and her chin, was pulled tighter.


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Questioner: Uneven nostrils after 2 rhinoplasties. What can be done?
After two rhinoplasty surgeries. my daughter's nostrils are uneven, and she is self conscious. Her nostrils were not uneven prior to rhinoplasties. To correct them, would she require a third rhinoplasty with general anesthesia? Would it be as hard a recovery? What can be done to fix them?
(Questioner submitted photos)

Dr. Denenberg's answer: Maybe, maybe, she could have a revision of only the columellar scar
In general, that view, the bottom view, is the least important view after a rhinoplasty (or before), because it's a view that people generally don't see. Achieving excellent symmetry in that view is unrealistic, and unnecessary.

Having said that, however, it seems that much of the asymmetry is caused by a bulge of scar tissue on her left side, at the location where perhaps the incision was made for an open rhinoplasty. Maybe revising that scar would help meaningfully, with no risk to the entire rest of her nose.

Link to this question on RealSelf.com