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Can my Nostrils Be Lowered or Changed?

asked 1 year ago by mari in michigan
Latest answer by Mark B. Constantian, MD
Question viewed 891 times
Tags: bridge, nostrils, female, hump, lower, straighten

Hello, I have a interesting question. I had septoplasty/rhinoplasty surgery about 16 months ago and I am bothered by my nostril show now. My nose before just had a little hump which I can still see a little. The bridge if my nose is not straight as it should. The tip was not changed which I requested because I felt my septum or middle hanging area was lower the my nostrils. The tip was never touched and now I have nostrils that looked pulled back a little. Like I'm mad all the time. Help :)

14 answers to Can my Nostrils Be Lowered or Changed?

Changing nostrils with Rhinoplasty or Revision Rhinoplasty

From your photos, it appears that you have what's called "columellar show" as a result of alar (tip lower edge) contraction or "notching" from your prior Rhinoplasty. The 'alar notching', typically occurs when to much tip cartilage is removed during a Rhinoplasty allowing the lower edge of the nostril to rotate up, creating a notch. This gives the illusion of the nostrils being rotated upwards. "Columellar show" is a term given... more

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon

Nostril retraction following rhinoplasty can be repaired

Dear Mari: Nostril retraction following rhinoplasty can be repaired. My colleagues have shared many tips for dealing with ala-columella disproportion and there has been discussion involving pushing the nostril margin down as well as pulling the columella back. Based on your photos which are pretty good (thank you), it appears that the issue, as you suggested is that your nostril has retracted. I would recommend either an alar rim graft or a composite graft inside the nostril depending... more

Stephen Weber, MD
Lone Tree Facial Plastic Surgeon

www.lonetreefacial.com

Can my Nostrils Be Lowered or Changed?

The reason for the nostril elevation are given by others. I suspect you had a closed or endonasal rhinoplasty. With open rhinoplasty, this problem rarely happens as the lower cartilages are secured with sutures at the dome and therefore, they won't be able to rotate upwards. The treatment is to reverse what was done which means adding cartilage to the sides of the nose while lowering the retracted nostril skin. This has worked very well on many patients. The columella may also needs to... more

Mohsen Tavoussi, MD, DO
Huntington Beach Facial Plastic Surgeon

Excessive nostril show after rhinoplasty.

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... more

Mario J. Imola, MD, DDS
Denver Facial Plastic Surgeon

www.cofps.com

Alar retraction or excessive columellar show after rhinoplasty

You may benefit not from nostril alteration, but from alteration of the columella and tip. Nostril alteration surgery alone is a great surgery, but in your case might result in an overly peaked appearance of the nostril.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon

All correctable

Dear Mari: I am a little skeptical that your tip wasn't touched, because it has that appearance, and tip changes can alter nostril visibility. However, if you are sure, the nostrils will also become more noticeable for two other reasons: First, when the bridge is lowered, the nose shortens, displaying more nostril. The amount of shortening is something that the surgeon can control, to produce the changes that you have requested. Secondly, I see that your middle third has... more

Mark B. Constantian, MD
Nashua Plastic Surgeon

Alar retraction v.s droopy columella

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

Kevin Sadati, DO
Orange County Facial Plastic Surgeon

www.galleryofcosmeticsurgery.com

Nostrils and Columella

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

Elliot M. Heller, MD
New York Facial Plastic Surgeon

Alar (Nostril Rim) Retraction

The retraction of the alar rim can be corrected with a cartlige graft placed under the skin at the edge of the nostril. Although it does not appear you have any contraction of skin inside the nose, a composite graft of both skin and cartilage is sometimes necessary. Slight lifting of the columella may be helpful - this would be determined at the time of physical examination.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon

Repairing alar retraction

Alar retraction can be repaired. Alar rim grafts involve placing a strip of cartilage within the alar rim margin to bring it down slightly. More severe retraction may requiring repositioning of the lower lateral cartilages. A composite graft to add tissue to the inside of your nostril is sometimes used as well, although I tend to avoid this in my practice as it may result in everting your nostril.

Thomas A Lamperti, MD
Seattle Facial Plastic Surgeon

You may be a candidate for a Non-Surgical Rhinoplasty to lower the height of your nostrils. Video attached.

I read your concern and reviewed your photos. You appear to have a bit of nostril retraction which is causing excessive nostril-show. A well-performed Injectable Filler procedure may be beneficial for lowering the height of your nostrils. In my practice, I prefer Silikon-1000, an off-label filler for permanent results. I hope this is helpful for you. Regards from NJ. see video

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon

www.ericmjoseph.com

Raised nostrils after rhinoplasty

The nostril can raise up and show the columella after rhinoplasty if the cartilage in the tip is over removed or the lining inside the nostril is removed or injured. The ala will notch or draw upward as in your photos and can give a bit of an angry look as you describe. Revision can bring the ala back down and into better balance, sometimes with a graft in the contracted area. It is discouraging that you believe the tip was never touched, yet your results show otherwise. Best of luck... more

Peter E. Johnson, MD
Chicago Plastic Surgeon

Excess Columellar show and Alar Retraction

You seem to have a touch of Alar retraction and columellar show. This was likely caused by partial resection of your lower lateral cartilages (which is a very common technique in rhinoplasty). The best solution for this is to add cartilage back to the Ala as a graft. The cartilage can come from either your septum (inside your nose) or your ear. A dorsum that is not to your liking can likely be corrected at the same time. Unfortunately the solution is... more

Leif Liu Rogers, MD
Beverly Hills Plastic Surgeon

Retracted ala after rhinoplasty

Retracted alar rims after rhinoplasty can be a challenge to improve. A composite graft from the ear my be required. Sometimes the columella may be further shortened to improve nasal appearance. See an experienced rhinoplasty surgeon for an opinion. Donald R Nunn MD Plastic Surgeon.