How can i correct the nostrils and the bump without making the nose shorter/elongating the philtrum? (Photos)

Question

Hi, how can i correct my nose without retracting the columella? I dont want to elongate the philtrum. What is causing my nostril exposition? Thanks

Erin Smith, MD · Answer

Hi, thanks for your question. Possible surgical goals could include reducing the dorsal hump and reducing columellar show.  The appearance of your nostrils is likely due to a low hanging columella, which can be due to elongation of the nasal septum and/or the positionining of the medial crura of the lower lateral cartilages. These issues be addressed surgically by trimming the nasal septum as necessary and repositioning the medial crura.

Zoran Potparic, MD · Answer

Based on these photos you are a very good candidate for a rhinoplasty; a hump reduction and columella shortening should be part of this surgery. In person consultation with a board certified plastic surgeon with expertise in rhinoplasty as well as 3D simulation may give you better idea what to expect. Good luck.

Ronald J. Edelson, MD · Answer

You have a bit of a hanging columella which should be shortened. This combined with lowering your bridge would create a nice profile

Mark K. Markarian, MD, MSPH, FACS · Answer

Hello and thank you for your question and photographs.  Although an exam in person is ideal, from your photographs alone it appears that you can, overall, benefit from a subtle dorsal hump reduction and a tip rhinoplasty where the nasal tip cartilage is modified for a more refined, feminine look.

To address your question about the nostrils specifically, I would recommend extended spreader grafts locked into a columellar strut which would add tension to the tip, coupled with extended alar contour grafts.  This maintains the nose at length and thus:
(1)  Prevents the nose from shortening -- the columella would no longer retract and pull on the philtrum (which prevents elongating the philtrum).
(2) Prevents over-rotation of the tip -- this would further prevent the philtrum from elongating. 
(3) Prevents the ala (rim of the nostrils) from retracting -- this would prevent excess nostril exposure.

Further modification of your nasal cartilage can be done with trimming, stitching or further grafting.  Of note, if you have any breathing difficulty, a septoplasty or other maneuvers may benefit you as well, and insurance can cover this to reduce the price of your surgery overall☝️

For more information on rhinoplasty, please refer to my link below.

Good luck and please let me know if I can help.

Mark K Markarian, MD, MSPH, FACS
Harvard-trained Board Certified Aesthetic Plastic Surgeon in Boston & Miami

Steve Laverson, MD, FACS · Answer

Rhinoplasty is an individually planned and performed procedure.  If you do not want a "retracted" columella or a shortened philtrum, be sure your surgeon knows that so his/her/their plan produces your desired change(s).  If you're asking about nostril exposure from profile view, that is determined by alar-columella relationship.  Both alar rim and columella descent can be adjusted for your desired relationship.  EASY, don't stress.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you are a great candidate for rhinoplasty. Maneuvers for your surgery would include dorsal hump reduction, tip refinement, nasal tip deprojection, placement of extended spreader grafts to make sure that the tip is not overrotated, among other maneuvers. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Tanveer Janjua, MD · Answer

The key is conservative surgery. If your tip is lifted your philtrum will become longer. If the hump is removed slightly without causing a ski slope then tip and philtrum will remain the same. Alarplasty will reduce the nostrils and will not effect the philtrum or the tip in any significant way.
Regards
Dr. Janjua

How can i correct the nostrils and the bump without making the nose shorter/elongating the philtrum? (Photos)

Answers (7)

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