Is it possible to reduce the width of the nose when smiling without reducing how it looks at rest?

Question

I'm mostly fine with how my nose looks at rest and don't want to risk altering that for the worse. I know it's normal for a nose to look wider when smiling, but in my case, the way it flares really disrupts the overall balance of my face

Tanveer Janjua, MD · Answer

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 mimic 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.

Donald B. Yoo, MD, FACS · Answer

If you would like to preserve the appearance of your nose while at rest, but reduce the amount of flaring during smiling, then you may consider a neuromodulator injection like Dysport or Botox to the dilator naris to achieve this. It's nonsurgical and has virtually no downtime, and is temporary as the effects will wear off in 2-3 months.

However, if you are open to changing the appearance of your nose, albeit slightly, an alarplasty to reduce the width or flare of your nostrils or rhinoplasty to reshape the nostrils may be possibilities to explore with a surgeon experienced in Asian rhinoplasty.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Likely providing improved tip support could help accomplish this. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Is it possible to reduce the width of the nose when smiling without reducing how it looks at rest?

Answers (3)

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