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Addressing Nostril Size in One Rhinoplasty Procedure?

I'm about to have Rhinoplasty done and I asked my doctor to also narrow my nostrils in one surgery, but he said that its not wise to do it and it's an isolated procedure. I've never heard that before. I thought I can have my bridge narrowed down, reduce the size of my tip and perk up my nose at the same time as I wanted to narrow the nostrils. What do you think? Thanks.

Doctor Answers (11)

Alarplasty usually part of rhinoplasty procedure

+1

The alarplasty (nostril surgery) can be done as an isolated procedure, but it is usually done at the same time as the remainder of the rhinoplasty to include reducing the bridge, size of the tip, and narrowing the nostrils. If it is obvious that the nostrils need to be done, it should be done at the same time as your rhinoplasty. If not, it can be addressed at a later time.


Seattle Facial Plastic Surgeon
5.0 out of 5 stars 58 reviews

Variations in surgical options for rhinoplasty

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Many surgeons would be willing to perform all this procedures at one setting but your individual surgeon may have a different opinion about this due to concerns with blood supply to the tip being compromised. This will cary from surgeon to surgeon.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 44 reviews

Rhinoplasty with nostril narrowing

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The portion of the rhinoplasty procedure you are talking about is called an alar base resection. It basically narrows or decreases the size of the nostrils.

If I am 100% sure I need an alar base resection, I do it at the time of the initial rhinoplasty surgery. However, if I am the least bit uncertain if it is necessary I will advise my patient that this may be done as a minor seconddary procedure under local anesthesia at no charge to the patient. Remember this is not something that can be reversed after it is done so this portion of the surgery should not be taken lightly.

Sounds to me like your surgeon is using good judgement but if you are still unsure seek another opinion. Good Luck.

Steven Schuster, MD
Boca Raton Plastic Surgeon
4.5 out of 5 stars 3 reviews

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Rhinoplasty and nostril reduction.

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Hi!

You are probably a borderline candidate for nostril reduction, and your surgeon wants to see what you wil look like afterwards and decide if you really need it.  This is very reasonable, and I have done it myself a number of times.

The nostril reduction alone is very simple surgery.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

Nostril size adjustment and Rhinoplasty can be done together

+1

The beauty of surgery is that no two surgeons think and practice exactly alike. There is often no absolute right way of doing things and there are several ways to arrive at a satisfying result. However, this can also be confusing for you if you seek multiple opinions for your concerns.

While some surgeons may be reticent to recommend simultaneous nostril narrowing and tip work, there really is no need for concern in this situation. Many rhinoplasty and revision rhinoplasty surgeons, including those who do open rhinoplasty routinely, would not have an issue with doing these procedures together. In fact, we routinely perform alar base (nostril) narrowing in those who would benefit from it at the same time as we perform their open rhinoplasty with tip reduction.

The key is to be comfortable with the surgeon you have chosen. By all means, ask all the questions you need to feel comfortable but, at some point, you have to give over your trust that he or she will do right by you. Seeing several doctors in consultation can often help you to decide what feels right for you.

Good luck.

Jason Litner, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 26 reviews

Rhinoplasty and Nostril Narrowing

+1

Hi N,
It is not usual to perform rhinoplasty and wait for the nose to heal before re-evaluating the need for nostril narrowing. Especially if the nostrils are borderline.

It is better to avoid an external scar and irreparable change if possible.

You have chosen your rhinoplasty surgeon hopefully based on results, skill, and experience. Therefore at this point I would listen to the surgeon's recommendations.
Good luck and enjoy your new nose.

Dr. P

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 23 reviews

Rhinoplasty

+1

 In general, all of the procedures that you describe can be preformed at the same time.  If you provide pictures of yourself, we may be able to give you more specific advice.  Good luck with your procedure.

David Shafer, MD
New York Plastic Surgeon
5.0 out of 5 stars 57 reviews

Each doctor is different

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I have been doing noses for over 30 years and do it all in one operation. If at the end of the surgery, I am not sure if you need a nostril reduction, I won't do it. But 95% of the time we will do an alar base resection at the same time as the main surgery. The is something that the skill of the surgeon will dictate.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.0 out of 5 stars 9 reviews

Narrowing notril size in Rhinoplasty

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It is possible. A lot of surgeons are hesitant to do it at the same time as other rhinoplasty steps like tip refinement, hump reduction etc. The reason is two fold;

1. It can be hard to assess till the end of a rhinoplasty as to how much a nostril should be changed.

2. If an open approach is used, the blood supply to the nasal tip is a bit compromised and doing wedge excisions of the alar area (nostrils) can be risky.

Here is my solution to this issue;

I make the nostril reduction the first step in my surgery. I mark and cut out the extra nostril wedges but do not close it. During rhinoplasty there is a lot of pulling and it can break the stitches. At the completion I suture the cut wedge areas of the nostrils. If you wait to do the nostril wedge resection till the end, there usually is swelling of the nose which can make it difficult to judge how much to resect.

Regards

Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 25 reviews

The blood supply to the nose

+1

The idea is to respect the blood supply to the skin of the nose. When an open rhinoplasty is performed few of the blood vessels supplying the nasal will be divided to access the deeper structures.

While the nostril excision procedure (weir's procedure) could be performed in the same time, I would still have to respect your surgeon's decision as he is trying to perform the safest procedure possible. The nostril procedure could be done later under local.

Hope that helps!

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 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.