Can Rhinoplasty narrow a wide nose and still look natural?

Great question!  Yes - In general, rhinoplasty surgery can narrow a wide nose and still look natural.  A few things you may want to consider...

First, which part of the nose would you like to narrow, the upper portion (called the dorsum or bridge)?  If so, this procedure is performed under anesthesia and requires making small breaks to the bone.  The dorsum can be narrowed with or without tip refinement.  Often, some tip refinement is done providing a smooth transition from the tip to the bridge.

Narrowing the nasal-tip is also a common request.  Both of these procedures can be done and absolutely look natural; although, there is the possibility of the results looking pinched or unnatural if done incorrectly or excessively.  It is very important to preserve a smooth transition from the tip to the dorsum/bridge to avoid a pinched or parentheses deformity to the tip.

Finally, and perhaps with the most controversy, is the subject of the nostrils.  In general, I feel the nostrils should only be done occasionally and judiciously.  It is very natural to have nostril flare (curvature of the nostrils - curving out, then in).  Removing all nostril flare or having the nostrils joining directly to the face without any curve results in a very unnatural look.  The procedure requires making small incisions on the outside of the nose which could leave scars and is almost impossible to reverse if over-done.

Several famous entertainers have had this over-correction done, turning many away from rhinoplasty.  This procedure has also been over-done in many Asian patients.  To achieve the most natural appearance, it is important to preserve the ethnicity of the nose.  Our concept of facial beauty has evolved and we are now including nostril flare as an acceptable and even desirable trait.  A great example of balancing ethnicity and facial beauty is Rihanna, who has a beautiful nose with a very defined tip, but prominent nostril flare.

That being said, there are times when excess nostril flare may be reduced to produce very nice results.  We have several examples of this on our website:  www.yourfaceinourhands.com  You will notice the results are modest and natural appearing.

One last tip...when seeking a surgeon for this type of procedure, please make sure that your doctor is a board-certified plastic surgeon, specializing in rhinoplasty.  Always ask for patient referrals and to see before/after photographs of patients with similar goals.  It will definitely behoove you to do your homework and find a surgeon with the experience and qualifications before scheduling a surgery.

I hope this is helpful!

Respectfully,

David C. Mabrie, M.D. FACS

There are two operations that might be just right for you.  Nostril flaring is related to the action of the dilator nasalis muscles.  These muscles are used as accessory muscles of respiration during times of respiratory distress; they are partially responsible for 'nasal flaring'.  Dilator nasalis arises from the facial bones at a slightly superior point and runs medially and slightly inferiorly to insert into the ipsilateral alar cartilages of the nose. It acts to open the aperture of the nostril. If a patient complains of excessive nostril flaring, I will find and remove the portion of this muscle that attaches to the alar cartilages.

The other operation that you may be a candidate for is a conservative wedge resection of the outer nostril skin.  This does not change the nostril size, but removes excess thick skin that may be contributing to the nostril width.  I also recommend choosing an experienced Board Certified Plastic Surgeon when considering rhinoplasty surgery.

You asked a few different questions so here are answers: -- can you reduce the size of my alar base without reducing the size of my nostrils-- yes, alar base reduction can be performed a variety of techniques not all of which will reduce the size of your nostril. --can you prevent my nostrils from widening with smiling-- the nostrils are typically widened with smiling. The facial muscles responsible for this are important for several functions so you would not want to sever them. you can prevent a nose from plunging with smiling, but it is much more difficult to prevent your nostrils (alar base) from widening with smiling --can you bring in my (alar base) and make my nostrils wider-- this is a complex three dimensional question which depends on what part of your nose you want wider.

There are a variety of grafts which can be placed in your nose which can help widen the nose in different areas but widening a too narrow nostril is generally one of the more difficult tasks in rhinoplasty --the key to bringing in a wide nose in without it looking unnatural-- planning, surgical experience, knowledge of sophisticated rhinoplasty techniques, etc. Good luck