I'd like to have alar base reduction as my nostrils flare too much when I smile and my nose is flat & droops down. Should I have the nose-tip built up along with alar base reduction? Or will increasing height of my nose-tip reduce nostril flare enough to compensate? Will I need the bridge of my nose built up if I want the nose-tip built up to get a more natural look? Bridge height doesn't worry me too much
Alar Base Reduction and Bridge Implants on Asian Nose?
Doctor Answers (8)
Aesthetic Surgery on the Asin Nose
Narrowing the base of the nose and building up the tip usually work better in conjunction in the Asian nose, though every nose is different and will need individual planning. Based on your pictures, you will likely benefit from both tip support (collumelar strut) and narrowing of the Alar base. Whether you augment the dorsum is up to you. It will change the proportions of your nose if you do, which would look good, but less ethnic. A good way to approach the planning for your nose is to bring in pictures of noses you like so they can be discussed with your surgeon. He/She will give you an idea of what is possible and what will look natural on your face.
Your self-analysis is very accurate.The most natural result can be achieved by augmenting the tip and radix (superior part of the bridge), and narrowing the nasal base. This will give your nose more definition.
A Silastic nasal bridge implant can be performed on Asian noses quite easily and is inserted through an incision inside of the nose. The drooping down of the tip that occurs when smiling occurs from a small ligament that is attached from the upper lip muscle to the nose, and once this is released during the rhinoplasty procedure, the tip then stays static and is no longer dynamic. Alarplasty can be performed to narrow the nostrils to further balance the nose with facial features.
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Asian rhinoplasty usually requires alar base reduction and tip augmentation.
You are correct is what you want and having it still look natural. The tip and the radix(top of the bridge) need augmentation. The base will need narrowing as well. See an experienced rhinoplasty surgeon who does many NATURAL looking Asian noses .
Asian Tip rhinoplasty.
In my opinion, I would proceed with placement of a graft and lifting of tip to promote rotation and mechanical support against downturning with smiling. I would also advise the alarplasty becasue I do not believe that the above maneuver would create satsifactory reduction in the nostrils. I would also advise you to consider a radix graft (nasal bridge) but as you have stated, this is less of a concern for you. Without addressing the bridge, this is essential a tip rhinoplasty
Rhinoplasty and alar reduction
A dorsal onlay may bring out the nose a bit and reduce as much of a need for base reduction. But certainly the two can be done at the same time.
African American Rhinoplasty
Ethnic rhinoplasty is by far the most difficult of all cosmetic procedures.
It appears that you would require elevation and rotation of your tip, slight reduction of your anterior dorsum then small implant to reproject your bridge followed by a alar base reduction.
The bridge height has to be proportionate to the elevation and rotation of your tip. This is what we call deprojection - reprojection of the bridge.
Asian nose enhancements
Everyone's nose will widen with smiling, so please know that alar wedge resections are done mainly for correcting the aesthetic "balance" of your facial features. This may affect your "smile" in subtle and sometimes obvious ways. Elevating your bridge will create a taller nasal form and the illusion of less width at the nostrils.You are a good candidate for both bridge augmentation and alar wing narrowing. That being said, your nose is individually ethnic and natural as it is. If you are looking to change toward another ethnic standard, be sure it will "fit" properly on your face. I can see what concerns you, and so, please interview for a surgeon who truly understands what you are requesting.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.