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Narrowing Base of Nose Without Weir Excision- Suggestions?

I saw a doctor a few months ago regarding a rhinoplasty procedure. I wasn't exactly prepared so I'm going in again in a weeks to meet with him again. When I was there he did mention taking out some of the cartilage in my base (don't remember the specifics) and doing a weir excision. He didn't really feel the weir was necessary and I don't think I want that done either. Just wondering if I could get some advice on what would be beneficial to have done. Sorry for the creepyness of the eyes blurred

Doctor Answers (11)

Before Rhinoplasty: Need to see the results both ways

+2

Hello:

Before rhinoplasty, you need to see the result, with and without, Weir excision and nostril narrowing.

Frankly, if the plastic surgeon is uncertain, and you are undecided whether or not to have the nostril narrowing, I suggest that you have the doctor perform computer imaging.

You'll see on a computer screen the predicted result of  surgery - both with and without the nostril narrowing.

In other words:

  •    Version "A" would be the other rhinoplasty changes
  •    Version "B" would be the same rhinoplastic changes, but with the nostril narrowing added 

Then, you can decide which you like best.  This assumes, of course, the surgeon has the experience and talent to deliver the results that are depicted on the screen.  You can learn that by seeing an album of his before and after rhinoplasty pictures with at least dozens of cases to give you a sense of the doctor's talent and art form.

It is very difficult to envision some of these things without graphic examples.

Robert Kotler, MD, FACS
Facial Plastic Surgeon
Author, SECRETS OF A BEVERLY HILLS COSMETIC SURGEON
 


Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 56 reviews

Narrowing base of nose w/o weir excisions

+1

The only way to reduce the width of the nasal base is to perform weir excisions at the base of the nostril sill.  The removal and trimming of the lower lateral cartilage in the tip will narrow the tip of the nose, but will not change the base.

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 55 reviews

Narrowing Base of Nose Without Weir Excision- Suggestions?

+1

A photo of the base view would be helpful in evaluating the base of your nose however from the photos you do have wide and prominent lower lateral (tip) cartilages despite a well defined (narrow) domal, tip area.  Refining and narrowing this area would require a Tip plasty as part of a closed Rhinoplasty.  This, of course, a different area than the base of the columella.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 12 reviews

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Narrowing the Base of the Nose without Weirs

+1

On the basis of the one picture you submitted, Weirs are not necessary, but a view of the base of your nose would be helpful. Besides the different Weir incisions a cinching suture is sometimes used to narrow the base. You are smart to reconsult with your physician - when possible, I always encourage my patients to return to review the choice discussed during our initial consult. Both the patient and surgeon should clarify goals and expectations before this operation.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

Rhinoplasty

+1

The weir excision involves removing skin at the nose lip junction to decrease the distance between the lower outer corners of the nose. From your posted photos I do not see why that would be necessary in your case. The desired distance is equal to that between the inner and outer corner of an eye, about 32mm, and you already have that. I would think the usual infracture and trimming of the upper edge of the tip cartilages would suffice.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Wide nostrils and rhinoplasty

+1

From the photos, all your work can be done without external incisions.  Of course, and in-person examination is really the only way to tell for sure.  However, the nostrils do appear a bit wide.  To narrow the flaring effect, internal Weir's would have to be done.  This would eliminate any external incisions.  

Good luck. 

David Alessi, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 7 reviews

Why the Weir at the base of the nose

+1

There are many patterns of the Weir excision at the base of the nose and they can accomplish many things. Based on your photo, the Weir may help reduce any flair in the nostril as the height of the nose is reduced, and the excision can help reduce the width of the base of the nose which seems best set at the width of the inner corners of the eyes. When well done the scar is imperceptible.

Best of luck,

peterejohnsonmd.com

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 28 reviews

Alar Base Narrowing

+1

Hi,

There are several different ways to narrow the nostrils. Weirs technique was described by Dr. Weirs and the term is used for all alar base narrowing techniques. However, in my practice I use either a horizontal intra-nasal narrowing technique or a vertical narrowing technique. In your case I would suggest an intra-nasal narrowing technique. You can refer to my website for more information on this technique.

Best,

Dr.S.

Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
5.0 out of 5 stars 209 reviews

There are several techniques to reduce nostril size

+1

There are several different techniques that can be used to reduce nostril size.  Visit with an experienced rhinoplasty surgeon to see what is your best option.  Warmest regards.

Dr. Pippin

Gregory Pippin, MD
Metairie Facial Plastic Surgeon
4.0 out of 5 stars 7 reviews

Weirs

+1

As long an your alar base width os fine with you, i would avoid the weirs excisions. The natural shape of the base changes but, in some cases the tradeoff is worth it. Internal weirs or nostril sill excision is an option as is a cinchig suture

David A. Bray, Sr., MD
Los Angeles Facial Plastic Surgeon
4.5 out of 5 stars 6 reviews

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.