I have very high alar rims. Am I a Candidate for Non-surgical Rhinoplasty? (photo)

I have very high alar rims which are natural, not the result of a previous rhinoplasty. I was wondering if it would be possible to have injections to lower my alar rims as opposed to alar rim composite graft surgery. I know that injections will not lower them completely, but would injections lower my alar rims enough to make some-what of a noticeable difference?

Doctor Answers 5

Non-surgical rhinoplasty to lower rims

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Dear Roadrunner,

  • There may be a safer way to inject filler without using a sharp needle that can get into a blood vessel
  • It may lower the rims 1mm or so which may be enough to make you happy
  • In the end, a surgical rhinoplasty is probably your best bet, you can lift the tip at the same time and prevent it from drooping as you get older

Best regards,

Nima Shemirani

Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 85 reviews

Non surgical treatment for high alar rim arch

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Given your photos, I would agree with Dr Chambers.  Surgical treatment of the alar rim carries a high risk of complications and this is also true for injectable fillers in this area.  I believe the best option may be a trial of botox in the Levator Labii Alaeque Nasi muscle.  Best wishes.

Vincent D. Lepore, MD
San Jose Plastic Surgeon
4.7 out of 5 stars 63 reviews

Non surgical rhinoplasty for alar rim arch

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Thank you for your question.

Firstly, I think you r nose does look very refined and you might not consider changing it.

I agree with my colleagues that nasal cartilage is not very forgiving to be played with. This is true for both surgery and non-surgical procedures.

If you are adamant that you would like to do something about it then I would suggest Botox into nasal alae and a small dose into Levator Labii aquenasii (it is responsible for lifting alae and flaring them). This combined with Silhouette threads to lift the tip of your nose a little will soften the alar arches

Non surgical rhinoplasty

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 Injections was placed into this part of the nose can only lead to complications such as necrosis. The best way to bring down alar rim notching is with composite skin grafts. This area the nose is best treated with surgical rhinoplasty.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Non-surgical alar rhinoplasty

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I do not think this will work in your case.  The alar cartilage is rotated into the high position and fixed, resulting in an arch that you don't like.  I don't think that the skin can be enhanced enough with fillers to make that up. 

What I really think needs to happen is that the alar cartilages need to be surgically divided, rotated, sculpted, and fixed into position using sutures and grafts.

best to you.



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