Nose profile is very small and straight but nostrils spread when I smile. Would an alar base reduction be a good idea? (photo)

I've always hated my wide nostrils. My nose profile is very small and straight, but my nostrils spread way too much when I smile - I hate photos. I don't want a full nose job (cost and family pressure), would an alar base reduction only be a good idea for my face?

Doctor Answers 10

Wide Nostrils?

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It is very difficult to give you sound advice from one picture but it does appear that your nostrils are too wide. When I hide your nasal tip and nostrils, I see a nice narrow bridge. Your nasal tip and nostrils are a little too wide for your face. You have beautiful eyes, high cheekbones, and a great smile.

Just for your own edification, not all plastic surgery is pricey. In my practice in NJ, the total cost for this surgery is $4100 which includes the professional, anesthesia, and facility fee. I can't help you with the family pressure as they love you for who you are. 

Consult a Board Certified Plastic Surgeon 

Alar base, wedge resection removal

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Yes, you could have an alar wedge reduction under a local anesthetic. This would, in fact, narrow the base of the nose and reduce the bulkiness there.

Alar-plasty to reduce wide nostrils

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The alar plasty procedure can reduce wide nostrils. The decision to perform the procedure is made at rest, not on animation. 2-4 mm of excess skin at the base of the nostrils can be removed under local anesthesia to narrow the  nostrils.

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Candidate for Alarplasty

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Hi Nikkiinuse,

It would be nice if you would also attach a photo where you are not smiling for comparison. From this photo however, I agree that your alar flares significantly when you smile and alarplasty will nicely improve your alar wing and nostril however, please understand that following alarplasty, there is a possibility that the tip of your nose will appear relatively more prominent though in reality, it's size will not change. Make sure you consider this possibility before deciding on any surgery. 

Am I a good candidate for alar base reduction?

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The wide nostrils can be reduced in size to create better balance.

Find a board certified plastic surgeon who performs hundreds of rhinoplasties and rhinoplasty revisions each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.

Kenneth Hughes, MD

Los Angeles, CA

Possible Alar Base Reduction Procedure

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If is hard to say for certain from the one frontal photo, but it does appear as if you might benefit from alar base reduction surgery. You will continue to have some degree of base widening with smiling, but the base of the nose can be made to be more narrow overall such that the widening is not as obvious. Make sure you consult with a board certified facial plastic surgeon who has lots of experience in rhinoplasty surgery. Wishing you the best of luck.

John M. Hilinski, MD
San Diego Facial Plastic Surgeon
4.7 out of 5 stars 44 reviews

Wide Nostrils

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With just one photo with you smiling it is difficult to judge the natural width of the lower 1/3 of the nose.  A relaxed photo without the beautiful smile would be helpful.  Your nostrils and alar base appear too wide.  Consult with a Board Certified Plastic Surgeon for an exam, and to discuss reasonable options.

Relationship between tip width and nostril width in alar base reduction

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An important aspect to evaluate when considering alar base modification is the relationship between the width of the tip of your nose and the width of your nostrils.  An alar base modification can cause the tip of the nose to appear wider.  Based on your pictures while smiling, an alar base modification may create better balance between your nose and your facial features.  An assessment of your nose in repose would be helpful in determining how much of a reduction could be performed while maintaining an attractive relationship between your tip and your nostrils.  

Donald B. Yoo, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 60 reviews

Am I a good candidate for alar base reduction?

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I agree with Dr. Peck's response. I would add one caveat that it is difficult to judge the natural width of the lower 1/3 of the nose when you're smiling. In many people this does create flare and widening in the nostrils. You likely are a candidate but a relaxed, non-smiling photo (or a consultation) would be helpful.

Stephen Weber MD, FACS
Denver Facial Plastic Surgeon

Flarring Nostrils

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The nostrils flare when you smile because the tip of your nose is falling. When the tip of your nose is supported with a columella strut you will have less flaring. Also once the tip is stabilized, more accurate conservative alar base reduction can be performed. 

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.