Are Combined Wedge & Sill Excisions Still Performed? (photo)

Is the method of procedure still preformed, 4 surgeons have already told me that they personally do not use this method due to the potential of scaring, i've only met 1 surgeon in the UK so-far who is willing to preform this way.

Doctor Answers 6

Wedge and Sill Excisions Still Performed

    Wedge and sill excisions are useful in patients with wide appearing nostrils.  What is needed will vary according to anatomy and patient desires.  Find the plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties each year.  Kenneth Hughes, MD Los Angeles, CA

Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Wedge and sill (Weir) excisions for alar base narrowing during rhinoplasty

These excisions are routinely performed for narrowing of the alar bases.  I prefer to keep the scar contained within the sill area, but the wedge is removed wherever it is needed to achieve the desired result.  The scar is never visible.

Daniel Greenwald, MD
Tampa Plastic Surgeon
5.0 out of 5 stars 45 reviews

Wedge and sill excisions

I use a variation of the procedure that you posted if the patient has significant flare and width of the nose.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Are Combined Wedge & Sill Excisions Still Performed?

Absolutely. In the correctly selected patient these excisions can result in a more narrow base of the nose, less flare of the nostrils or both. If performed properly, the potential scar typically heals very nicely. I've found that using skin glue on the skin portion of the incision results in a scar that looks good very soon after surgery. I hope this information is helpful.

Stephen Weber MD, FACS

Weber Facial Plastic Surgery

Stephen Weber, MD, FACS
Denver Facial Plastic Surgeon
4.9 out of 5 stars 129 reviews

Alar and sill excision with rhinoplasty

Yes, alar base reduction  with sill excision can be performed.  The incisions can be placed in a way that minimizes visibility with a technique that maintains the lateral aspect of the sill, otherwise you may get a Q-deformity and visible scarring.

Angela Sturm, MD
Houston Facial Plastic Surgeon
5.0 out of 5 stars 9 reviews

Weir rhinoplasty nasal sill excisions

These excisions are perform to change the alar width and contour of the lower third of the nose. Internal nostril sill excisions to narrow alar width is often used in Black + Asian noses. The scarring is barely noticeable as it is a the base of the nostril. 

What you have pictured with an external incision can cause scarring that is sometimes very noticeable. However, changing the alar margin this incision must be used and there is a small risk of noticeable scarring.

David Ellis MD FRCSC Toronto Facial Plastic Surgeon at Art of Facial Surgery

David A. F. Ellis, MD
Toronto Facial Plastic Surgeon
3.5 out of 5 stars 8 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.