The nose if very complex, but there are ways to reduce the nostrils

David Shafer, MD answers: Are there any approaches to nostril reduction?

Some nose jobs I've seen seem to have included nicely done nostril reduction. Is there just one approach to achieve such result (which will require external incisions on both sides of the wedges), or are there more approaches?


David Shafer, MD
12 months ago

This is a good question.

People often enquire about nostril reduction. The anatomy of the nose is very complex and often by changing one aspect of the nose the others change as well. So, it is often best to approach the nose as a whole rather than doing "quick fixes" to just one part. For reducing the nostrils, what you describe is an alar base resection - this essentially involves wedging out the lateral parts of the nostril and sewing them back together. In this procedure the incision is hidden at the base of the nose where the nostril is attached to the face. This is a nice procedure and produces excellent results.

I hope this is helpful.

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A: Nasal width reductions are specific to each problem

Robert M. Freund, MD
12 months ago

Nasal width reduction is used for different problems and thus the techniques are different for the desired result.

Problem #1-Very wide base with poorly projecting tip. For this problem increasing tip projection along with medially placed wedge resection works well. The wedge resection is usually well hidden.

Problem #2 - Very wide base, poorly projecting tip and rounded nostrils. Same as problem #1, but with added excision inside the nostril to flatten out the rounded nostril.

Problem #3 -Wide base with normal projecting tip. Wedge excision to narrow and shape the nostrils.

Problem #4 Wide base or Normal base in patient with large projecting nose. When the projection of the nose is reduced, the nostrils will flare out, thus requiring an adjustment of length, width and shape. The wedge resection for this type of nose will involve the largest amount of resection as well as scarring.

Most importantly, regardless of the technique or problem treated, all wedge resections should NOT be in the crease between the nose and the cheek. Although this may sound like the best place to put the incision, it results in the worst scars. Have your doctor place the incision just above the crease - it heals much better.

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A: Nostril reductions

Steven Wallach, MD
10 months ago

There are many different ways to reduce nostril size. This depends upon the relationship of the width of the lower third of the nose to the other areas.  Sometimes the base width of the nostrils has to be reduced, and can be combined to remove the nasal flare as well. So there are many variables.

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