Would rim grafts help my triangular nostrils appear more round? Looking for permanent solutions (photos)

Question

My nostrils are quite triangular. Would rim grafts be the best option for getting circular nostrils? I’m African American so it’s quite bizarre to see triangles. I don’t want filler because I’m wanting something permanent. Would this be a hard thing to fix?

Donald Groves, MD · Answer

Hello and thank you for your question and the pictures. You actually have a difficult problem. To permanently fix your triangular shaped nostrils, you would need a revision rhinoplasty with rim grafts to better round out the shape of your nostrils.

This is truly a surgery of millimeters! Because your nose is the DEFINING feature of your face- I would only recommend seeing a surgeon who specializes in revision rhinoplasty procedures, and who has significant training and experience performing these surgeries. I actually trained under one of the world leading rhinoplasty experts (who performs 1,000+ nosejobs annually).

I recommend for you to setup a formal consultation with me (or another plastic surgeon who is extremely comfortable with rhinoplasties) to thoroughly discuss your surgical goals, undergo a formal examination, evaluate your options, and develop a personalized plan just for you. I hope this helps!

Dr. Donald Groves
Aesthetic Plastic Surgeon

Oakley Smith, MD, FRCSC · Answer

Hi, It is better for you to consult with your facial plastic surgeon who can examine you and give you opinion based on examination. It is depend on surgical findings, to decide for proper way of fixing that.

Eric M. Joseph, MD · Answer

Based on your photos, I would suspect that you may have had previous rhinoplasty surgery. Inverted V appearance at your nostril margins could be due to nostril retraction. Depending on your examination, these areas may be lowered and softened with microdroplet Silikon-1000 injections. For many people, this is a welcome alternative to nasal surgery. I hope this helps. Sincerely, Dr Joseph

Ramin Behmand, MD, FACS · Answer

The notching you're experiencing is likely due to trimming of the lateral alar cartilage, followed by the closure of the incision inside the rim with a suture that may have been slightly too tight at the area known as the soft triangle. While fillers can offer some improvement, as you mentioned, their results are often temporary. A more lasting solution would likely involve placing a lateral alar rim graft or a graft in the notched area, along with potentially releasing the tighter scar tissue at that spot. The graft can be placed first to assess if it resolves the issue before considering any additional steps during the same procedure.

Dr. B.

Dr. B.

Zeshaan Maan, MD · Answer

Hi - I would strongly recommend seeing a rhinoplasty focused surgeon in consultation and identifying your goals and letting the surgeon you trust come up with the right plan to help you achieve those goals. 
There are multiple maneuvers that can be done to reshape the nostrils and you may need 1 or multiple of those maneuvers that could include cartilage grafts to strengthen the soft triangle facet.

Zoran Potparic, MD · Answer

It is very likely that a small amount of filler, properly placed would improve nostril shape. However, you will need an expert to do that; it is not a task for an injector. Good luck.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you may benefit from a tip refining rhinoplasty. Your surgeon can accomplish this by trimming, suturing, and reshaping the cartilage in your lower nose. Cartilage grafts may also be used to help improve tip refinement. Alar contour grafts can also be placed to help address the alar notching. 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

Sean Fisher, MD · Answer

Alar notching is best addressed surgically as it has to do with the structure and positioning of the lower cartilages of your nose. This can be addressed with a combination of reshaping/repositioning the cartilages that form the tip of the nose and alar contour grafts that further correct the area of notching that is present.
Sean M Fisher MD

Tanisha Hutchinson, MD · Answer

Hi there. Yes, rim grafts would add some structure to the area where your nasal ala are arched and lower that arch. At FACE Atlanta, we specialize in rhinoplasty including African-American rhinoplasty.

Mats Hagstrom, MD (license on probation) · Answer

From your pictures, it looks like you’ve already had an open rhinoplasty.
Did the nostril appearance change from this procedure? Rim grafts may help but can also cause visual disturbances and the dissection to place these graphs it’s not that straightforward. If the nostril change happens from the surgical change then it is less likely adding cartilage would help. I’m guessing this happened because the nose was narrowed?
Considering that this would be revision surgery things get pretty complex and I think you should rely on in person consultations.
Best,
Mats Hagstrom MD

Would rim grafts help my triangular nostrils appear more round? Looking for permanent solutions (photos)

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