Concerned With My Alars and Bulbous Tip? (photo)

I don't want any implants (silicone/gortex) and analogous tissue implants seem to be way out of my budget... I'm fine with my relatively low bridge. My primary concerns are my alars which look like round parentheses attached to the side of my nose, and the huge/bulbous/broad tip. Thanks for your help!

Doctor Answers 11

Alars and bulbous tip

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It is best to not operate on this type of nose since there is very little cartilaginous support in the nose and extremely thick skin.  This type of thick, oily, sebaceous skin will not heal well in the postoperative period and is a setup for a pollybeak deformity unless an implant is inserted in the bridge line.

Bulbous tip and wide alar base

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It is possible to narrow the tip and the alar base without augmenting the bridge of your nose. However, this may create a bit of a porcine appearance if some narrowing of the bridge and elevation of the dorsum does not occur as well. It is hard to tell from those limited photographs. I would suggest consultation with a rhinoplasty surgeon and get their opinion on this procedure that would best suit your needs.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

Alarplasty Or Rhinoplasty

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Dear Kim,


An alarplasty alone will not be the procedure that will help your achieve your goals.

You have to keep in mind that when the alar base is addressed along with the tip, your nasal dorsum will not fit. I believe that you are trying to achieve the L shaped nose.

Without physical examination and a face-to-face consultation, it is hard to provide you with a solid opinion of what should be done to reach your goals.

I recommend that you consult with a board certified surgeon of extensive experience who will guide you to make a well informed decision.

I hope this helps.

Thank you for your inquiry and the best of luck to you.

Dr. Sajjadian

Alarplasty and Rhinoplasty

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While Alar surgery may be done without Rhinoplasty to reduce the nostril area I am not sure this would be the best procedure for your exact problem. The photographs are difficult to give you a proper analysis without an examination. The best advice I would give you is to see an experienced Rhinoplasty surgeon for an evaluation and examination. Personally in my office I use a digital imaging computer which allows me to show my consulting patients the proposed surgical results. I would also look at your surgeons before and after photographs and make sure he has experience in different ethnic noses. Best regards!

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 212 reviews

Alarplasty without rhinoplasty

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It is possible to do alarplasty (removal of wedges from sides of nostrils) to reduce the width of the nasal base without doing a full rhinoplasty.

The procedure is minor but has to be very precise.


Dr. J


Disclaimer: This answer is not intended to give a medical opinion and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.

Concerned With My Alars and Bulbous Tip?

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Restricted posted photo hinder full decision making. Best to see a few boarded surgeons in your city to discuss the options IN PERSON. 


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Ethnic Rhinoplasty is what we are talking about.  No Dorsal bridge work needs to be pursued.  Look to the alar base and tip support for your best changes.

Alar Base Reduction & Nasal Bulbous Tip Refinement

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Alar base reduction to decrease flaring of the tip and bulbous tip refinement can be done without changing your bridge. Select a surgeon experienced in ethnic rhinoplasty.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 40 reviews

Alar Base Reduction

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This is a very common request from ethnic patients, particularly because flaring is noted with smiling.  The alar base can be nicely brought in to achieve an outstanding result.  With some nasal tip definition, your tip could be less bulbous.  I don't recommend implants if you were to build your bridge up, but to use your own tissue and cartilage instead.  Please consult with a board certified specialist who can assist you in achieving the results you seek that are also balanced for your face.

Kimberly Lee, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Asian Rhinoplasty

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  Thank you for providing photographs with your question.  It makes having a realistic discussion about rhinoplasty a little more attainable. 

  I think you have a well proportioned nose that would benefit from subtle refinements to improve the definition of the nasal tip.  I do not think you need resection of your nostrils or reduction of a large nasal tip.  Rather, by adding a little projection and rotation to the tip of your nose your nostrils will be brought into balance without needing to be reduced in size.  Also, rather then reducing the size of your nasal tip I would recommend reorienting it's cartilages to add a little more definition. 


  Both changes to the tip and nostrils can be accomplished with rhinoplasty.  If you have a small nasal bridge I would encourage you to be open to possible changes to the dorsum as well.  Many surgeons do not charge extra for implants or cartilage but rather incorporate it into the over rhinoplasty fee.  Also, it is easier and more predictable for me to achieve the desired outcome when I have control over all the variables in rhinoplasty: tip, nostrils and bridge.

  Spend time thinking about all of the features of your nose with which you are happy and the ones you would like to improve.  Before proceeding to surgery meet with a few different providers and select the one that you feel most comfortable with.   


Hope this  helps.

Christopher Kolstad, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 58 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.