For an African American rhinoplasty revision, can the tip projection be decreased and alar base/nostrils flare be restored?

Hi Janeconnor. First, I always recommend talking to your original surgeon about your concerns because you are completely correct- s/he knows exactly what maneuvers were performed and can best tell you what can be done to achieve your goals. However, if you've lost trust in that surgeon or want 2nd opinions, you can certainly consult with another surgeon but I wiould still try to get your op note so that the new surgeon knows what was done. In general, the tip projection and tip position can definitely be changed- might be as simple as shaving or repositiniong a septal extension graft- but it is going to be much much harder to add back the nostril flare. Good luck!

Reversing tip projection and alar base narrowing are definitely possible. While decreasing tip projection is relatively easy, restoring nostril flare is slightly more complicated. When the alar base is narrowed, tissue from the nasal floor, alar wall or both are sometimes removed. On my website, I talk about the various ways of approaching this, depending on what was removed and how much. If minimal amounts of tissue are removed from the nasal floor, intranasal flaps may be used. However, for larger amounts of tissue from the nasal floor or alar wall, either composite (skin + cartilage) ear grafts or paranasal flaps may be necessary.