Hi there!The best way to ask for a narrower nose in your case is to ask that the nasal alae and the nasal sills are reduced, as well as asking for osteotomies to narrow the nose. Although I cannot see your nasal profile, I am suspecting that you have some underprojection of your nose/nasal tip, and would benefit from augmentation of the dorsal and possibly also the caudal septum (anterior septal angle) to help with that, which will also result in some narrowing of the nasal appearance from the front view. (That might require a rib cartilage graft harvest).Most importantly, you should realize that your nose likely needs to be grafted, not significantly reduced, in its cartilage structure, in order to look more narrow and streamlined, even though this seems to be the opposite of what you want. (Hint- it is all about shadows and light!) If your surgeon over-reduces the structure of your nose, it will look wider and less defined due to the type of skin and cartilage framework you have been born with. Good luck!Elizabeth Blasberg, MD
Hi there! You are correct, as the swelling has come down, the proportions have changed and the top of the nasal dorsum has decreased in projection, while your tip has rotated upwards, along with some mild alar retraction. There is definitely persistent swelling at the supratip and nasal tip region. You should give the nose an entire year before you decide whether you like your outcome, especially since you have thicker nasal skin, sometimes I even suggest waiting 15 months for those with medium to thick nasal skin as swelling lasts longer. I would recommend doing nasal lymphatic massage (massage by grasping the tip of your nose with your first three fingers and massaging upwards towards the eyes using some gentle pressure. Do this for one minute in the morning and one minute in the evening. If you don't get much change to your liking by 12-15 months, you could benefit from a very small radix graft to augment the top of the nasal dorsum between the eyes, and some septal trimming to make the tip smaller. Good luck!Elizabeth Blasberg, MD
Hi there!I took a look at your photos. I think the best option for you would to have composite ear conchal cartilage alar rim grafts for alar rim lowering. The reason I recommend composite grafts (cartilage with skin attached) is because they tend to resorb the least of all alar rim grafts and provide the best outcome. You could achieve an improvement of 2-3 millimeters which would be the ideal alar position. Your right side is slightly more retracted than your left side, so that will have to be accounted for when your surgeon harvests the grafts. Additionally, you should know that the alae will look lower that you would like (overcorrected) for 3-6 months if it has been done correctly. The contraction of the graft (inevitable) will cause some retraction of the alar length after grafting, so if overcorrected, the result should end up being appropriate once your nose has had time to heal and contract. Otherwise, from what I am able to see, your nose has ideal aesthetic proportions! Some surgeons may perform this procedure under sedation in the office, whereas others might recommend anesthesia in the operating room. It would also depend on your preference. Good luck with your facial plastic journey!Elizabeth Blasberg, MD.
