How difficult is to correct alar groove/collapse? (Photo)

Question

After seeing so many noses I realized the prettiest and most attractive ones are the noses without prominent alar markings. It’s really rare to see surgeries fixing this cosmetic issue though ! My nose used to be “ round “ before I had a rhinoplasty , then, I don’t know if too much cartilage was taken , or what went wrong but now I have very prominient alar creases / grooves. Please forgive me if those aren’t the correct names . I would like to know if it can be fixed

Walter Joseph, MD · Answer

Hi Lipslikesugar! Dr. Walter Joseph here from Beverly Hills, CA. From what I can see in the photos, after your rhinoplasty, you were left with a very distinct demarcation between your ala and your tip. This can be fixed using cartilage grafts to smoothen that transition between your ala and your tip. By securing cartilage grafts from your tip complex and having those grafts articulate with your lower lateral cartilages and then having those same grafts extend laterally into the alar rims, it is possible to smoothen that transition that you're seeing and create a more natural appearing nose. I hope this helps!

Jonathan Kulbersh, MD · Answer

Thank you for your question and photos. I’m sorry that you’re unsatisfied with your initial rhinoplasty results, but through a personalized surgical plan with a qualified surgeon, revision rhinoplasty can correct the issue you’re referring to and enhance the appearance of the nose. This may require cartilage grafting and restructuring of the tip, though a thorough physical examination is required to determine the necessary steps for your case. 
Please keep in mind that each subsequent nose surgery becomes more complex due to the loss of structural support, scar tissue, and other variables. The importance of experience, expertise, and artistry cannot be overstated. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon, with expertise in rhinoplasty techniques. They will be able to review your surgical history, assess your concerns, and describe the steps that can be taken during revision to address them.

David M. Kowalczyk, MD, MBA, FACS · Answer

Good Morning! Great questions. Sometimes during rhinoplasty, too much cartilage is removed and not enough camouflage placed to create natural contours. The tip can appear isolated in appearance not flowing well from tip to ala. This can be improved with revision rhinoplasty. Certain grafts like temporalis fascia can be used to "soften" the tip. The tip may need complete restructuring but it is possible. I would seek consultation with a facial plastic surgeon to learn more. Hope this helps!

How difficult is to correct alar groove/collapse? (Photo)

Answers (3)

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