How could I lower my arched nostrils? (photo)

Question

Can anyone advise about how to lower my arched nostrils? I like my nose other than this and wouldn't like to have it dramatically reshaped. I have spoken to one doctor and he says only ear cartilage will help and even then it won't be that effective. Are there any other techniques that could help please?

Robert Glasgold, MD, FACS · Answer

On the photo it appears that arched appearance of the nostrils is due to both retraction of the alar rim and accentuated by the long columella.  Surgery can absolutely improve this, it would require restructuring the tip cartilages since that is what is contributing to this.  Cartilage grafts are likely to be needed, but septum could be used if there is enough remaining cartilage to work with.

Edwin F. Williams, III, MD · Answer

I see and hear your concern.  The usual technique for correcting an arched nostril is insertion of a rim graft.  A complete set of photographs and in-person exam of your nose would be needed to determine the exact surgical plan.  Our philosophy of rhinoplasty is to rebalance the nose to work in harmony with the rest of the face.  Sometimes this means also making other small adjustments to other areas of the nose to achieve that harmony.  Best of luck!

Bora Ok, MD · Answer

Hello,
Thank you for your question.Alar retraction may be acquired by surgical procedure or genetically and this area needs to be supported. This problem can be resolved by supporting with cartilage tissues. 
But ;of course ; consultation is required to make a final assessment.
Best Regards.
Bora Ok, MD - Plastic, Reconstructive and Aesthetic Surgeon

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your
photograph, you have alar retraction causing this appearance of your nostrils.  You may benefit from alar rim grafts to lower the position of your ala.  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.  You should be able to
view numerous pictures of actual patients with noses similar to yours performed
by your surgeon.  Best wishes and good luck.
Richard G. Reish, M.D. FACS
Harvard-trained plastic surgeon

Barry L. Eppley, MD, DMD · Answer

Alar rim retraction can be improved by alar rim cartilage grafts. Such a technique can lower the height of the alar rims by 1 to 2mms.

Jeffrey T. Steitz, MD · Answer

Lowering an arched nostril is one of the more challenging endeavors in rhinoplasty.  The technique depends primarily on what the true problem is which can be multifactorial.  Sometimes it truly is arching of the nostril margin which can be caused by previous surgery, weak cartilage and scarring.  Other times it is less of an arched nostril and more of a hanging columella which is caused by excess cartilage in the septum and nasal spine.  
An in person exam will be more helpful with determining the true cause in you.  But there are several powerful methods for lowering a nostril margin.  Typically ear cartilage is too weak to hold the margin down, but septal cartilage and/or rib cartilage can usually hold the margin down longterm if used appropriately.  
Since this is a problem most frequently encountered in revision rhinoplasty, I would seek out a facial plastic surgeon who specializes in revision surgery and is comfortable with various grafting materials including rib grafts.  Good luck!

How could I lower my arched nostrils? (photo)

Answers (6)

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