How to prevent 'pinching' and deep supra alar crease lines in Ethnic Rhinoplasty? (Photos)

Question

Hello! I am an African American girl considering a rhinoplasty to correct my flat/wide nose. The only thing i like about my nose is that i do not have deep supra alar crease lines. I am very concerned about the appearence of these lines and possible 'pinching' of the tip after ethnic rhinoplasty. I would like to know what surgical techniques are required to prevent these issues. Thankyou!

Evan Ransom, MD, FACS · Answer

Thank you for the great question and your photos. The crease or groove where the nostril meets the cheek/upper lip is generally not changed if the alar base reduction is performed conservatively. In my practice, I use a combination wedge and sill excision for non-caucasian rhinoplasty. This allows a decrease in the overall width of the nose at the bottom, without creating a sharp angle or flat nostril. For the supra-alar crease, it is easy to avoid making this deeper by not over-resecting the lateral ends of the tip cartilages and/or by placing a cartilage graft under the tip cartilage here to avoid pinching and give support.

David Alessi, MD - Account Suspended · Answer

There are 2 creases that we are concerned with in wider/ flat noses.  The alar crease, which is what I think you are referring to, can be changed if the lower cartilage dissection is carried far laterally.  This is usually not needed.  Even if the dissection is far lateral, the crease rarely changes.  The other crease is the junction between the cheek and the nose.  This crease is kept from being to sharp by a combination of internal and external incisions.  Seek out an opinion from a board-certified rhinoplasty expert.  Best wishes.

How to prevent 'pinching' and deep supra alar crease lines in Ethnic Rhinoplasty? (Photos)

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How to prevent 'pinching' and deep supra alar crease lines in Ethnic Rhinoplasty? (Photos)

Answers (2)

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Everything you need to know about African American Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.