Nostril flare and tip over-projection (Photo)

Question

My nose is both too wide at the nostrils and also too projected at the tip. My understanding is that reducing the tip projection often causes the nostrils to flare even more. I guess I'm wondering if it's possible to reduce the projection of the tip and the width of the nostrils simultaneously? Is it usually only possible to prioritize one of these concerns?

Bora Ok, MD · Answer

Hello from Istanbul! Yes, it's possible to reduce both the tip projection and the width of the nostrils simultaneously. In fact, as you said, deprojecting the tip can cause the nostrils to appear wider, so an alarplasty is a good idea for achieving a balanced and harmonious result. Best of luck to you!

Anya Costeloe, DO · Answer

You are a great candidate for rhinoplasty with an alarplasty, also known as alar base reduction. The rhinoplasty would reduce your tip projection and an alarplasty is a surgical procedure that reduces the width of the nostrils. It primarily focuses on the alar region, which is the outermost part of the nostrils and I often recommend this for patients who feel that their nostrils are too wide or flared. I frequently perform the rhinoplasty and alarplasty at the same time.
During the alarplasty procedure, I makes small incisions in the creases where the nostrils meet the cheeks and removed the excess tissue to narrow the nostril width. The result is a more proportionate and narrower nose that complements your other facial features. I hope this helps! - Dr. Costeloe
Facial Plastic SurgeryNational Harbor, MD

Andrew Miller, MD · Answer

Based on your photos, you are a great candidate for rhinoplasty. The length of the tip can be reduced and the tip could be made less boxy at the same time. While it's true that deprojecting the tip can make the nostrils flare a bit, if you are reducing the nostril size anyway, that could be taken care of easily. Be sure to see a rhinoplasty specialist for consultation.

John Michael Thomassen, MD · Answer

A rhinoplasty to reduce the tip projection by setting back the tip slightly can be done.  If the nostril flare is a concern, a slight alar base reduction can be added to address this.

Steven M. Denenberg, MD · Answer

You didn't post any 3/4 views, which show the width of the *tip* of the nose best, but the frontal view seems to suggest that the two cartilages that form the tip of your nose are broad, and can be narrowed at the same time. The nostrils can be narrowed as well, at the time of deprojection of the nose.

How *much* to narrow the tip, or deproject the nose, 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. For most noses, 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.

Zoran Potparic, MD · Answer

Based on these two photos it appears that you may consider rhinoplasty. However, it would be very difficult, based on these photos, to give you food advise related to your questions. In person or telemedicine consult with an expert in rhinoplasty should be your next step. Hope this helps.

Lexie Wang, MD · Answer

It is absolutely possible to deproject AND decrease the nostril flare. You would need to make sure your surgeon does address both of them. There is not necessarily one that gets prioritized more, although I will say that usually the nostril flare part of the surgery is done at the end, so how much can be done there will be dependent on the deprojection.

Gary M. Horndeski, MD · Answer

The tip can be reduced and the base width narrowed. In your frontal view, this is slightly enlarged but not greatly. The cartilage is reduced and the skin will be conformed over time to the reduced size of the underlying frame.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Eric M. Joseph, MD · Answer

We can see a wide nasal appearance on front view and that you have an overprojected tip and a small dorsal hump on profile. Rhinoplasty surgery may be considered for achieving narrowing in the upper middle and lower thirds of your nose with the projection of your nasal tip and bridge as well. In fact, deprojection of your nasal tip would make the width of your nostrils slightly wider. Alar plasty, or nostril narrowing, is commonly performed along with rhinoplasty. I hope this helps! Sincerely, Dr Joseph

Paul E. Chasan, MD, FACS · Answer

Thank you for your question. You are an excellent candidate for rhinoplasty. I agree with your assessment and think it is one of the most beautifying surgeries that we do as plastic surgeons. A large portion of my practice is dedicated to rhinoplasty surgery. It is important to only see plastic surgeons with extensive experience in rhinoplasty, ie perform at least 6 per month and have performed hundreds of cases. Also, critically evaluate on-line galleries to see if their art form resonates with yours. Rhinoplasty is definitely a grey haired plastic surgeon's sport. Best wishes to you.

Nostril flare and tip over-projection (Photo)

Answers (16)

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