Lowering nostrils (name of procedure and possible doctors who perform such a surgery)

Question

I hate the position of nostrils but love the tip of nose and mouth Nostril height from side is normal, just not the base of nostril, it’s too high. 2 surgeons only want to perform hump reduction + nose lift + lip lifts but I HATE(!!!) where the nostrils are on my face, its too high and does not have any balance. I love other parts of my face and I don’t want them changed. If the nosetip is lifted up to the place of the nostrils it looks squished and piggy. I hated simulation. I like long noses

Eric M. Joseph, MD · Answer

I understand your concerns about where your nostril connects to your upper lip, however, alarplasty procedures and rhinoplasty procedures are not designed to improve upon this concern. If you're otherwise please with the appearance of your nose, it may just be best to live with what you have. I hope this helps. Sincerely, Dr Joseph

Tanveer Janjua, MD · Answer

Alarplasty will pull down the sides of your nostrils and reduce the nostril height from front and side views. 
Alarplasty is a very fine and quick procedure that can narrow the nostrils and reduce the flare to soften the appearance. It has other names as well like ‘Weir Excisions’ or ‘Nostril Reduction’. It can be done under local anesthesia. The social down time is about a week. If you want to work from home you can start it the next day. For the procedure you are evaluated to determine how much of a change is needed. In the past surgeons had recommended 2mm to 5mm reduction. This was measured by drawing a vertical line at the lateral sides of the nostrils (alae). However, I prefer to use a mirror and Q-tips to show the patient how much of a change can be accomplished. Pushing with Q-tips from the sides can mimick the change. Patient can also pinch their upper lip near the base of the nose and will show them how much narrowing to expect. I try to quantify the change as small, medium and large. Rarely it can be extra large as well. I always advise the patients to be conservative in the change as it is an irreversible procedure. The procedure historically did not get a lot of attention in plastic surgery. It was always thought of an adjunct procedure done with a rhinoplasty. Historically most ethnic groups did not get rhinoplasties. Hence, the caucasian rhinoplasty was the main procedure that plastic surgeons were trained on. 15 years ago I started making videos on the procedure and putting them on YouTube. In my blogs I started using the term 'Alarplasty' as most doctors and patients were using the term nostril reduction or Weir Excisions. I started noticing that over years the term 'Alarplasty' became popular among patients as well. Today, most patients use the term freely and know a lot about the procedure. I am very excited to see this evolution over the years. My African American patients were especially happy to learn that you can make the nose look small without having to do a full rhinoplasty. Many of them noticed that every plastic surgeon they went to offered a full rhinoplasty. 
In summary, Alarplasty is a unique procedure in itself and hopefully more surgeons get trained in it and help more people.
You can visit our alarplasty website to learn all about it. 
Click on the video link below to see the details.
Regards
Dr. J

Mats Hagstrom, MD (license on probation) · Answer

Moving your nostrils is possible, but it tends to leave a contour that is unnatural.
Your current natural transition from your lip to your nostril will be changed in an unnatural way by attempting to do what you are requesting.
I also don’t see a strong need for what you’re asking for.
 The recommendations, your surgeons are offering you are based on experienced, including a good understanding of what procedures can, and cannot accomplish with quality outcomes.
I suggest you resist the temptation of making your own assessment and prescribing your own operation.
Even I as a plastic surgeon try not to do that when consulting with other physician, including plastic surgeons.
I listen to their advice, and then if the plan seems reasonable, I let my surgeons make the final decision of what is in my best interest.
While I may have the expertise to make a reasonably good assessment, I am inherently biased about my own facial appearance. We all tend to me. 
Focus your efforts on finding the most talented and experienced rhinoplasty surgeon.
This is by far the most important variable.
In the hands of the right provider you’ll be guided towards having a procedure that will deliver quality outcomes.
Best,
Mats Hagstrom, MD

Lowering nostrils (name of procedure and possible doctors who perform such a surgery)

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Lowering nostrils (name of procedure and possible doctors who perform such a surgery)

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