It’s one of the most disheartening things a patient can experience: going through the emotional and physical process of rhinoplasty, only to find that your nose looks — or feels — uneven.

Maybe one nostril is higher than the other. Perhaps the bridge looks crooked when you turn your head, or your tip is drooping again. Sometimes, the asymmetry is subtle, but you notice it every time you take a photo. Other times, it’s more than aesthetic — the imbalance affects your breathing, your self-esteem, or both.

At Kowon Plastic Surgery in Gangnam, we see many patients from Korea and abroad facing this very situation. Whether it’s weeks, months, or even years after their primary surgery, they come to us with a simple but difficult question:

“Can this be fixed?”

The answer is often yes — but correcting uneven results requires more than just “touching up.” It demands a deep understanding of nasal anatomy, experience with revision techniques, and above all, a commitment to doing things safely and precisely.

Let’s explore what causes uneven results after rhinoplasty, what options exist for correction, and how we approach these complex cases at Kowon.

Why Do Some Rhinoplasty Results Turn Out Uneven?

First, it’s important to recognize: the nose is a complex, 3D structure, and even small differences in structure or healing can create visible asymmetry.

Here are some of the most common causes we see:

1. Implant Misalignment or Shifting

In Korea, many primary rhinoplasties still use silicone or Gore-Tex implants to raise the nasal bridge. But these materials don’t always stay in place. Over time, the implant may shift slightly to one side, or create an unnatural contour — especially if not securely fixed or if the underlying cartilage wasn’t properly stabilized.

2. Asymmetrical Cartilage Grafts

If cartilage grafts (often from the septum or ear) are not shaped or positioned symmetrically, the nose may appear crooked, bumpy, or uneven over time. Even a millimeter’s difference can be visible on a central facial feature like the nose.

3. Scar Tissue and Healing Irregularities

No matter how skillful the surgeon, healing is never 100% predictable. Internal scar tissue (fibrosis) can pull the nose slightly out of alignment as it contracts. Some patients develop thick scarring on one side more than the other, especially in revision cases or in noses with prior trauma.

4. Underlying Structural Weakness

Sometimes, the problem isn't what was done — it's what was left behind. If key structures (like the septum or nasal tip support) were weakened or over-resected in the first surgery, the nose may collapse asymmetrically over time.

Signs Your Nose May Need a Revision

Not every asymmetry requires surgical correction — but some signs should prompt a consultation with a revision rhinoplasty specialist:

• One nostril is noticeably larger, higher, or collapsed

• The bridge appears crooked or slanted in photos

• You feel breathing is more difficult through one side

• The nasal tip droops unevenly when you smile

• You can feel or see the edge of an implant

• Your nose looks different from one angle to another

What many people don’t realize is that a second rhinoplasty is not just a repeat of the first. Revision requires a different mindset, more delicate techniques, and often, more advanced tools — especially when previous surgery involved implants or structural over-resection.

How We Fix Uneven Rhinoplasty Results at Kowon

At Kowon Plastic Surgery, we approach every revision case with one central goal: to restore balance, structure, and function — safely and naturally. Here’s how we do it:

Step 1: Comprehensive Assessment and Imaging

Before planning any correction, we start with an in-depth consultation that includes:

• 3D facial analysis

• Endoscopic nasal evaluation

• CT scan (if structural deviation or breathing issues are involved)

• Detailed photographic review from multiple angles

We also carefully review your surgical history — including operative reports and any previous complications. If those aren’t available, we infer as much as possible from clinical findings and imaging.

Step 2: Identify the Root Cause of Asymmetry

Every uneven result has an underlying cause. Some of the most common we diagnose:

• Implant deviation or capsule contraction

• Septal deviation or perforation

• Collapsed lateral wall (alar retraction)

• Tip graft misalignment

• Rib cartilage warping (from previous grafts)

Once we understand why your result is uneven, we can determine whether the solution is minor (such as scar release) or major (such as full structural reconstruction).

Step 3: Choose the Right Surgical Approach

No two revision cases are the same, but here are some of the most effective techniques we use:

Implant Removal and Rib Cartilage Reconstruction

If an implant has shifted or created asymmetry, we typically remove it entirely. Instead of replacing it with another synthetic material, we use the patient’s own rib cartilage, harvested and reshaped to match their nasal framework. This allows for:

• Greater stability

• Lower risk of future shifting or infection

• Precise contouring for symmetry

Dr. Kim Hyung Taek, our medical director, is internationally known for pioneering implant-free, rib cartilage-based rhinoplasty — especially in revision cases where structural rebuilding is essential.

Tip Reshaping and Support Reconstruction

A drooping or twisted tip is often caused by weak or misaligned lower lateral cartilages. In these cases, we re-shape and re-support the tip using cartilage grafts — either from the septum, ear, or rib — to restore projection and alignment without over-bulking the nose.

Septoplasty and Functional Correction

When breathing issues accompany asymmetry, functional correction is essential. This may include straightening the septum, reinforcing the internal valves, or removing internal scar tissue to improve airflow.

Importantly, form and function are deeply connected in nasal surgery. A nose that breathes well often looks better, too — and vice versa.

What Makes Revision Rhinoplasty So Challenging?

Many patients ask us: “Why couldn’t my first surgeon get it right?”

The truth is, even highly skilled surgeons may face limitations during a primary rhinoplasty — especially if shortcuts are taken or if the nose was particularly complex to begin with. Revision is harder for a few key reasons:

• Scar tissue distorts anatomy

• Original cartilage may be weakened or missing

• Less donor material (like septal cartilage) is available

• Patients are more sensitive to subtle changes

This is why you need a surgeon who not only performs rhinoplasty — but specializes in revision. At Kowon, Dr. Kim performs a limited number of surgeries per day to ensure full focus, especially for patients coming for difficult corrections.

Healing After Revision: What to Expect

Revision rhinoplasty typically involves longer recovery than a first-time surgery, both physically and emotionally.

• Swelling may last several months, especially in the tip.

• Internal healing can take up to a year, especially if cartilage grafting was involved.

• Nasal symmetry improves gradually as tissues settle and fibrosis softens.

We follow every patient closely through this journey — with routine check-ups, manual therapy if needed, and open communication. Most importantly, we emphasize realistic expectations: no nose is perfectly symmetrical, but balance and natural harmony is achievable.

A Word of Advice If You’re Considering Revision

If you’ve had a rhinoplasty and something just doesn’t feel or look right, trust your instincts — but don’t rush into a second surgery. Take the time to:

• Allow your nose to heal fully (we recommend waiting at least 6–12 months post-op)

• Seek a board-certified revision specialist

• Avoid clinics that promise fast fixes or reuse the same implant-based methods

• Ask about cartilage-based techniques and long-term safety

At Kowon Plastic Surgery, we’ve seen firsthand how thoughtful, structural revision can not only restore aesthetics — but also a patient’s confidence, breath, and peace of mind.

Final Takeaway: You Don’t Have to Live with an Uneven Result

A rhinoplasty that didn’t go as planned can feel deeply disappointing — but it doesn’t have to be the end of your journey.

With the right surgical plan, personalized approach, and careful execution, most uneven noses can be corrected. The key is to choose a clinic that specializes in the complexities of revision — one that prioritizes safety, structure, and natural-looking outcomes.

If you’re considering revision rhinoplasty, especially after implant complications or asymmetrical results, Kowon Plastic Surgery in Seoul is here to help.

Need an expert opinion on your previous rhinoplasty result?
Schedule a consultation at Kowon Plastic Surgery — where each case is treated with precision, empathy, and artistry.