Can my Nostrils Be Lowered or Changed?

Overly visible nostril openings is a not uncommon complaint following rhinoplasty.  The cause is usually due to upward rotation of the tip or inadequate resection of the columella in a patient who had borderline excessive nostril show before surgery.  Alternatively, alar retraction due to scar formation pulling the nostril margin upward can also cause this.  It is hard to say exact what has caused this in your case, however, the degree of deformity is luckily not very severe. 

Correction can be achieved by resecting a strip of cartilage along the free edge of the septum at the columella and/or inserting a sliver-shaped cartilage graft into a pocket along the nostril margin (alar rim graft).  It may be advisable to attack the problem from both ends and perform both maneuvers.  Note, however, that alar rim grafts are a fussy technique and can alter the shape of the nostril margin, which in your case is nicely arched.  It requires attention to detail to get it right.  Both the columellar resection and the alar rim grafts can be performed using a closed rhinoplasty approach and the residual hump on your bridge can be further reduced through this approach as well.

Dear rhinoplasty patient,
It appears that you have a ptotic or droopy columella giving the appearance of an alar retraction. A simple procedure to correct your problem is to resect or remove the caudal (bottom) portion of your septal cartilage to lift the columella. This procedure will bring a harmony and balance in your nostril and columella appearance. It can be performed with local anesthesia. Good luck and good healing. Dr. Kevin Sadati

The bottom columella portion may need to be lifted a little. Nostrils can be lowered through the alar rim.