Reducing the nostril width without any external incisions? (Photo)

Question

I have a good height nose but wide nostril which i want to make small so that my nose looks sharp..my surgeon has recommended a correction for wide nostril through the mouth without any external incisions while enhancing my jaw and correction of lip ......am not clea

Jacob Sedgh, MD · Answer

Some degree of reduction of the nostril flare can be achieved indirectly with tip work (by increasing the projection of the nasal tip, resembling a tenting effect). You might be a candidate for such tip work based on your picture, but obviously more views and detailed understanding of your goals are needed before such decision can be made. As far as direct reduction, it always requires incisions, but some can be made inside the nose, some outside (junction of the nose and upper lip) and some through a combination of both.

Afshin Parhiscar, MD · Answer

Dear jayaa
Unfortunately, there is no good way to reduce the alar base width without removing some skin and soft tissue, This leads to a small, well hidden and permanent scar. The good news is that it usually heals very well and is barely visible.  In your case, I would not recommend reducing your alar base without narrowing your tip as this will lead to your tip looking larger.Look for an experienced and well trained plastic surgeon certified by the American Board of Plastic surgery or Facial Plastics, see more than one consult and make a well informed decision.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  It is possible to decrease the alar base width with an internal nasal sill excision.  This is performed inside the nose, not through the mouth.  Based on your
photograph, you also may benefit from a tip refining rhinoplasty.  Make sure you specifically look at
before and after pictures of real patients who have had this surgery performed
by your surgeon and not just a computer animation system.
The most important aspect is to find a surgeon you are comfortable with. I
recommend that you seek consultation with a qualified board-certified plastic
surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D. FACS
Harvard-trained plastic surgeon

Manish H. Shah, MD, FACS · Answer

Hello,Thanks for your question. You can narrow the nostril width using an incision in the upper central gumline under local anesthesia. This allows your surgeon to use a pursestring type suture to cinch the nostril width closer together. The only problem is that aggressive narrowing might lead to redundant skin at the nostril sill. This is an old technique, but effective in certain cases. I perform nostril narrowing on patients of color all the time. The incision externally heal incredibly well and are typically not noticeable after a few months. I would counsel you to be careful with any nostril narrowing if you have no plans to have a tip rhinoplasty performed to deal with the large round tip of your nose. The visual imbalance will be very unappealing. In fact, an isolated alar base/nostril narrowing procedure is rarely performed without tip surgery for balance.I would recommend that you consult with a rhinoplasty specialist in your area for more information.Good luck,Dr. Shah

Evan Ransom, MD, FACS · Answer

Thank you for the question and the photo. Changing the nostril shape in rhinoplasty can take many forms. In a lot of cases, nostril shape can be changed by making changes to the position and shape of the tip cartilages -- without making an external incision at the nostril rim. However, for a significant reduction in the size or thickness of the nostril, a small incision at the nostril opening or where the nostril meets the cheek is needed. With careful execution, this will heal with minimal scarring. Other, more esoteric, ways of changing the nostril position do exisit -- such as cinching sutures placed through an incision made under the lip -- but these don't often have good long-term results. Best of luck and take care!

William Portuese, MD · Answer

It is possible to completely hide the incisions on the inside of the nostrils, however this technique does not allow significant width reduction. When a significant amount of skin is required,  the incision is located at the base of the nostrils along the nasal sill.

David A. Sieber, MD, FACS · Answer

Thanks for the great question. I've never heard of a way to narrow the nose through the mouth. In order to achieve good shape and correction, there needs to be a scar along the base of your nose. If done carefully, this scar should barely be visible. Best,~Dr. Sieber

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