Alarplasty on thick skin?

Question

Not only are my nostrils very wide and flared they are also unevenly shaped. They are also very large in height if that makes sense. I would like to not only reduce their size horizontally but also vertically. I also want them to lay back more and form to the countour of my tip instead of protruding outwards. At the end of the day i want my nostrils not to be most noticable part of my nose. Is that possible with thick skin? and how do you prevent the triangular shaped nostril opening like mj?

Brock Ridenour, MD · Answer

Alarplasty or nostril reduction involves removing a portion of nostril to achieve a more pleasing shape to the nose. The procedure should be tailored to the individual needs of the patient. Alarplasty can reduce the outer curvature of the nostril, the internal circumference of the nostril, or both. Careful consideration should be given to both the inner and outer shape of the nostril when planning the procedure. The incision should be placed in an inconspicuous location and the nostril curved into the floor (sill) of the nose to achieve a natural appearance (no triangles). To achieve the ideal tip shape, alarplasty is usually performed as part of a complete rhinoplasty procedure. Reducing the vertical height of your nostril would not be advised as it would require reducing the projection of your nasal tip. Instead, I would advise increasing the projection of the tip, thus making the vertical height of the nostril appear proportionally less. Hope this helps.

Toby Mayer, MD · Answer

Alar plasty in the thick skinned nose.You're a larger base can look much improved. If you were expecting perfection you will be disappointed. It also depends what else you want done to the knows whether a rhinoplasty should be combined with this.  See a very experienced rhinoplasty surgeon who has results you like. Do not rely on imagery.

John Layke, DO, FACS · Answer

After reviewing your photos, I believe that you are a good candidate for rhinoplasty and alar base/nostril reduction.  If performed correctly, this should not leave a notched, or "triangular" appearance.  I recommend consulting with a Board-Certified plastic surgeon who will accurately examine your nose, create a simulation based on what your nose COULD look like after surgery, and create a plan tailored to your individual needs.  Best wishes!

Tamir Mosharrafa, MD · Answer

Thank you for your question and photos. Based on the images, I think you are a good candidate for a rhinoplasty. One issue to consider is the projection of your nasal tip. A graft in the midline (called a columellar strut graft) will help in your case as it will increase your tip projection, open up the angle between the base of your nose and your upper lip (columellar-labial angle) and also bring in you alae, similar to the way a central post in a tent brings in the sides as it is elevated. Additional maneuvers could be done to enhance the change achieved by this graft, but this will go a long way to helping you achieve your goals.

William Portuese, MD · Answer

An alar-plasty can be performed on thick skin individuals, or thin skinned individuals. Performing an alar plasty  will only narrow the base of the nostrils.

Wafik A. Hanna, MD (retired) · Answer

Dear summersday19   Thank you for your photographs and your question.  It's easier to reduce the width of your nostrils but not the height.  You will need a columella strut graft to elevate your tip and narrowing your tip.  I would seek an experienced rhinoplasty surgeon.  Wish you the very best.

Richard W. Fleming, MD (retired) · Answer

Many if not most patients who would benefit from an alarplasty and narrowing of the nasal base have thick skin. External incisions are usually avoided in these patients because they do not heal well and cause unfavorable scars.

Michael Elam, MD (retired) · Answer

Dear Summerday19,  In my opinion you would do best with a rhinoplasty including alar reduction so that modifications may be made in the nasal tip and bridge of the nose providing more support for the tip and  projection. Then the alar-palsty would be performed and resulting in a much more aesthetically pleasing result. "no triangles" Best regards, Michael V. Elam, M.D.

Alarplasty on thick skin?

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