Seeking a more feminine nose - alarplasty or nasal tip plasty? (Photos)

Question

Hi, I am unhappy with the size of my nose. My nostrils are quite long and become quite animated when I smile/express myself. It makes me self conscious. I don’t want full rhinoplasty. Are there any more minor procedures that would help? Alarplasty?? I am seeking a more feminine nose.

Steven M. Denenberg, MD · Answer

Your nostrils are long because your nasal tip is long. Actually, the word we use is "projecting," which means the tip comes out forward away from your face more than we'd like. In addition, the tip sits low and could be elevated, and the two cartilages that form the tip are strong and broad, and narrowing those cartilages would help as well. You have a great look, and would do very well with a rhinoplasty in expert hands, but there is no "minor" procedure (like an alarplasty) that would make any difference at all, so don't let anyone talk you into one.

How *much* to elevate the tip, or bring the tip back closer to the face, or narrow the tip, or make other changes? We figure that out with morphs, well before surgery. I'd love for you to see some excellent professionally-designed morphs of what could possibly be done with your nose. Morphs could also help you identify better just what's bothering you, and help you set a goal for the rhinoplasty that's accurate for your tastes. Profile and three-quarter views would be particularly important in morphing your nose. (Side note: in my opinion, morphs should really be done by the surgeon, or he should direct an assistant as she makes the morphs. Morphs should be made with a constant eye to what actually *can* be done in surgery, for that particular nose, and the surgeon has that information and judgment best.)

Finally, remember that rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes that your nose needs require advanced techniques, and skill that most plastic surgeons don't possess with expertise. It's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. And it also discusses how to take photos that are best for online evaluations.

Eric M. Joseph, MD · Answer

Based on your photos, you appear to have a crooked nasal tip appearance which is wide and over projected on profile. Over projected means it sticks out too far. Since the tip of your nose appears to veer to the right, this could be associated with the deviated nasal septum. If you have severe dissatisfaction with the appearance of your nose, please consider meeting with several reputable rhinoplasty specialists so you could see what might be best for you moving forward. I hope this helps! Sincerely, Dr Joseph

Matthew Bridges, MD, FACS · Answer

You need to go see a rhinoplasty expert to discuss the process.  I see a lot of discussion about "tip-plasty", "alar-plasty", etc.  Those terms are misleading, with people assuming they can be done with a magic wand under local anesthesia with no recovery.  Don't get hung up on the semantics of rhinoplasty.  Let an expert guide you through the process in person.  The recovery is typically pretty easy. I do all rhinoplasties, whether the tip is modified or not, via the closed approach.   The recovery is much easier with this method.

Robert Ciardullo, MD · Answer

Alar plasty and nasal tip plasty vs. full rhinoplasty: rarely can a nose look its best with just a tip plasty and or alar plasty, however you might be one of the few who could get away with that more limited procedure. Your tip is bulbous and over projecting. The goal would be to reduce the width and projection of the tip and reduce the size of the nostrils. That might not give you the absolute best possible result, but it would probably be close enough to make you happy.

Seeking a more feminine nose - alarplasty or nasal tip plasty? (Photos)

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