Do they cut the lower lateral cartilage when performing a nose job ?

Question

I am thinking about getting a rhinoplasty and I have been doing my research about everything including how they perform the procedure. If I was to get a reduction in the length of my nose as well as the length of my nostrils , do they cut the lower lateral cartilage to achieve that? would the nose need new support to be put in place if i choose to have a nose reduction?

Caner Kacmaz, MD · Answer

Thank you for your question and photo. You are a great Candidate for Rhinoplasty, surgical instruments known as rasps and osteotomies (hammer and chisel) are used to reshape the nasal bones by removing the hump and/or narrowing the nasal bone width. These tools are relatively imprecise and their use can lead to contour irregularities, etc. if not used in the proper manner. Recently, a technology that uses sound waves has been developed to contour nasal bones in a precise and far less traumatic way when compared to traditional techniques. Ultrasonic, or Piezo, Rhinoplasty is now the most advanced technology available for minimally traumatic nasal bone reshaping and hump removal during Rhinoplasty. There will be hardly any bruising and swelling which will make the recovery period a lot easier for the patient.

Pejman Aflaki, MD · Answer

Hello and thank you for your question. It is common to trim the lower lateral cartilages, which is intended to improve tip bulbosity and refine the nasal tip. It is important to avoid over-trimming as it can lead to alar collapse and interference with breathing. . My best advice is that you discuss your concerns and aesthetic goals with a board-certified plastic surgeon with extensive experience in performing rhinoplasty. I would ask to see before and after pictures of their real patients. It's important that you trust your surgeon's skills and ability to achieve the results you are looking for. In particular, pay attention to your surgeon's experience with rhinoplasty. Best,
Pejman Aflaki, M.D.
Johns Hopkins-trained double board-certified plastic surgeon

Gary Linkov, MD · Answer

Rhinoplasty requires exceptional skill on behalf of the surgeon and great communication with the patient about realistic goals and expectations. Common cosmetic concerns include a dorsal hump, wide nose, sunken nose, irregularities, and asymmetries. Functional concerns include difficulty breathing through the nose, which can and should be addressed at the same time as your rhinoplasty.

In your situation, the lower lateral cartilage is not necessarily removed but it may be reconfigured with suture material.

Find someone you connect with, who will listen to your concerns and provide you with a framework for what is possible.

Gary Linkov, MD 
Rhinoplasty Specialist 
Manhattan

Ronald J. Edelson, MD · Answer

I’m not sure what you mean when referring to the length of the nostrils. The lower lateral cartilage reduced the bulbousness in the tip and is a common part of most rhinoplasties. If you resubmit your question with photos it would be helpful.

William Portuese, MD · Answer

To reduce the bulbous Nasal tip requires cutting a  conservative portion of the lower lateral cartilage in the nasal tip. Suture techniques are also performed when there's wide and boxy nasal tip cartilages. A closed rhinoplasty approach can accomplish your goals by placement of all the incisions on the inside of the nose. No external incisions are required, and no  Painful packing is required.

Do they cut the lower lateral cartilage when performing a nose job ?

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