Addressing Nostril Size in One Rhinoplasty Procedure?

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.

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.

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... more

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.

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,... more

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

 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.

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.

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... more

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!

Nostril size is often included in a rhinoplasty procedure. This procedure is called a Wier Excision Procedure. Although this procedure is not employed in every nose job,  I routinely perform it when it is appropriate.