How do I navigate life with a congenital defect?

Dear Alice,

I was born with a congenital defect which is extremely obvious. I have three nostrils. Throughout my life, I have obviously experienced ridicule. I have learned to deal. I find that instead of people just asking me, they stare and talk. It's something which frankly, I'm not used to. What do I do to deal?

— Three-nostril monster

Dear Three-nostril monster, 

You describe yourself as a monster, but you may feel better knowing you’re not alone in your experiences. About three to four percent of babies are born with congenital defects, and many of these defects are visible. While this condition may make you feel othered, it certainly doesn't make you a monster. It’s also important to note that no matter how you feel about your congenital defect, you don’t owe other people an explanation about the way you look. How people choose to react to your facial difference isn’t a reflection of your character but rather a reflection of the person who’s reacting. There’s no one correct way to handle these situations. While it might be difficult to navigate these negative responses, you can decide for yourself if you want to engage with the person staring or not. 

For those who are unfamiliar with the condition, having more than two nostrils is called supernumerary or accessory nostrils. Though relatively uncommon, it has been reported a number of times in the last century. It’s also possible that more people have a third nostril but haven’t reported it, or perhaps they’ve chosen to undergo procedures to change their nose. Its cause is unknown, and many instances are reported in children or appear alongside other congenital anomalies. 

Many people with facial differences or other disabilities experience stares or questions about their appearances. Some people might stare and not ask because they’re not sure how to approach a conversation without coming off as rude or judgmental. Some people may also stare out of curiosity. You have the choice to talk to people about your congenital defect or ignore them entirely. How people with facial differences approach these situations can run the gamut. While some may choose to give others little to no information about their condition, others may choose to speak out about their condition regularly and in detail acting as an advocate for the condition. 

You mentioned that it frustrates you that they don't ask about it while staring at you. Have you ever tried to start a conversation with the person when that happens? You may find that some people are looking for permission to ask questions or begin a discussion. If you choose to discuss your facial difference with others, one strategy you might try is preparing your answer in advance. This involves thinking about the typical questions you might get about your supernumerary nostril. You could also think about how you feel when others stare at you because of it and craft a response to those questions. Being able to talk to others about your extra nostril could help people understand what it’s like to live with a visible facial difference and how you’re perceived because of it. 

People with supernumerary nostrils may experience struggles with body image or self-esteem because of their facial difference. Employing some coping mechanisms may be helpful in trying to develop greater self-esteem and a healthy body image. Some of these strategies may include directly challenging negative thoughts, going through cognitive behavioral therapy (CBT) with a mental health professional, or finding a support system to talk to about how you feel. 

Many people and organizations are able to provide additional support if you choose to pursue it. There are organizations dedicated to ending stigma around facial differences and communities of people who may have similar experiences as you do. One example is Changing Faces, which has resources about facial conditions and how to talk about them, along with online communities of people living with visible differences. If you're feeling harshly judged or experiencing worse than weird looks and questions, it may be best to speak with a trusted friend, family member, or health care provider about your experiences. They can help remind you that beauty is more than skin deep and you are not defined by your facial difference.  

Last updated Dec 15, 2023
Originally published Oct 01, 1993