Rhinoplasty Alternative for Broad Nose After Orthognathic Surgery?

Question

I had orthognathic surgery (leforte 1), 5 months ago to correct a gummy smile. The surgery has caused my nose to broaden at the base when I smile even though my doctor used an alar stitch. Is there anything that can be done to correct this other than Rhinoplasty?

Otto Joseph Placik, MD · Answer

There are a few considerations here. Is it wide at rest or with smiling?
If it is the former, you may benefit from an alar base resection along the nostril sill also termed a modified Weir excision. This can be combined with another alar cinching suture.
If the wide nose occurs with smiling, this can be softened with the use of Botox.
Discuss this with a plastic surgeon, as there may be other alternatives.

Toby Mayer, MD · Answer

Without a photo it is difficult to say. Narrowing the base is probably going to give you the desired result. This is a minor procedure, under local anesthesia and you could go to work the next day.

Eric M. Joseph, MD · Answer

You should consult a board-certified, experienced, Rhinoplasty surgeon to discuss your options. Narrowing the base of the nose is a fairly simple technique, that is usually performed at the time of Rhinoplasty when the alar base is wide.
I don't think there is a non-surgical alternative.
If you'd like to post / email me a full-facial photo, I'll be happy to share my thoughts.
I hope this helps, and best regards.

Darryl Coombes, FRCS(OMFS), FDSRCS(Eng) · Answer

This a complication of undergoing a maxillary impaction Le Fort procedure. Your surgeon has placed a Cinch suture in an attempt to narrow your alar base width- the truth is these do work and if anything are temporary.

	What should have been done at the time of the procedure was bony contouring of the priform aperture base. This could have minimised the alar base widening.

	A Rhinoplasty (not just excising excess skin) will be required to correct this problem now.

William Portuese, MD · Answer

A broad nose can be made narrower through osteotomies or rebreaking of the nasal bones.  The nasal tip can be made smaller through some tip suturing techniques as well.  Alar-based Wier excisions can be performed that reduce the alar bases.

Rhinoplasty Alternative for Broad Nose After Orthognathic Surgery?

Answers (9)

Answer: Wide alar base

Answer: Wide alar base

Answer: Procedures to reduce a broad nose

Answer: Procedures to reduce a broad nose

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Rhinoplasty Alternative for Broad Nose After Orthognathic Surgery?

Answers (9)

Answer: Wide alar base

Answer: Wide alar base

Answer: Procedures to reduce a broad nose

Answer: Procedures to reduce a broad nose

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Recommended reading

Everything you need to know about Jaw Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.