Should I Have Alar Base Reduction, Tip Work or Both? Any Other Suggestions? (photo)

I have a bulbous tip and wide nostrils. I know how difficult it is to thin out the skin from a nose, but think it might be my only choice. I'm not convinced about the alar base reduction because I'm afraid it would make me look unnatural. I'm latino btw.

Doctor Answers 8

Probably both, but maybe just the tip

It is a little unclear from the pictures, but probably both.   Definitely the tip and maybe the alar base.   The alar base is a little wide, and the tip is bulbous and lacking definitiion and projection.  The skin actually does not look overly thick to me and I suspect you can have quite nice result with a rhinoplasty. 

Best regards,

Dr. Lane Smith 

Las Vegas Plastic Surgeon
4.5 out of 5 stars 93 reviews


It appears that from the limited pictures that you have too much supra-tip fullness and inadequate tip projection. I do not believe that you need an alar base reduction. Of course, these recommendations are limited by the fact that I am unable to examen you in person. It is important that you be evaluated by a Board Certified Plastic Surgeon that also has plenty of experience with rhinoplasty surgery.

Michael A. Epstein, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 48 reviews

Bulbous Tip and Tip Depression During Animation and Rhinoplasty

     The tip size can be reduced and the depression during animation can be improved by dividing the depressor.  The nostrils and alar base probably do not need to reduced, particularly if you are unsure.  Find the plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties each year.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Rhinoplasty - tip and/or alar base reduction

Tip rhinoplasty works nicely even with thicker skin. Certainly, your tip can be thinned during surgery to some extent.

Alar base reduction would be a judgement your surgeon will have to make after examining you in person and perhaps during intra op evaluation.

Good luck!

Ahmed Abdullah, MD, FACS
Fargo Plastic Surgeon
4.9 out of 5 stars 18 reviews

Alar base reduction and tip surgery

 The bulbous tip can be addressed with a combination of tip suturing techniques and cartilage removal. Close followup with your rhinoplasty surgeon will most likely include cortisone shots to the supratip area of the nose in the first few months after the surgery. Alar base reductions are performed when the nostrils are quite wide, but it's impossible to tell from these photographs

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Rhinoplasty Question #nosejob

Your questions are difficult based on the photos that you show. There are many different maneuvers that can be done to reshape the nose. It is very important that you are clear with your surgeon about exactly what you are looking for. Only then can the surgeon make suggestions about what they feel you need. I often will be in the middle of a Rhinoplasty and find myself needing to perform maneuvers that I was not expecting to perform. Alar base resections can be needed at the end of a Rhinoplasty when you did not expect doing it. Tip work is very common when having a Rhinoplasty. You have to leave some of this up to your surgeon and that is why you must trust them completely before you decide to have a Rhinoplasty by anyone. Find a board certified surgeon who specializes in Rhinoplasty and does a lot of them

Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 49 reviews

Rhinoplasty for the polybeak, underprojected nose with weak alae.

Rhinoplasty for the polybeak, underprojected nose with weak alae is what you need with or without nostril reduction. Make sure you see a very experienced rhinoplasty surgeon for the best result.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Alar Base Work Versus Tip Reshaping Versus Both

The photos, unfortunately, do not allow proper assessment of the nose as it sits on your face. That being said, using the photos shown you might benefit from tip rhinoplasty without base reshaping. The nasal base has to be approached with caution as it is very unforgiving if improper changes are made. 

John M. Hilinski, MD
San Diego Facial Plastic Surgeon
4.7 out of 5 stars 40 reviews

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.