Closed rhinoplasty if I need alarplasty/ tip plasty & what exactly needs done to achieve desired results? (Photos)

Question

Updated: From my pictures what would the rhinoplasty to achieve what I’m looking for consist off. I’m assuming an osteotomy, tip plasty and an alar base reduction. Would those give me a smooth narrow nose with a small defined tip. I don’t want my nose any shorter since that throws of my facial balance. I want to reduce the amount of scarring since I’m aware Afro Caribbean skin is prone to keloids. On a previous question it was suggested that I may need soft tissue thinning at the tip, lateral and medial osteotomies, alar base reduction and my infratip lobule tucked in. Would this require an open rhinoplasty or would closed work for me. I’ve attached pictures of my current nose and what I’m hoping to achieve.

Eric M. Joseph, MD · Answer

We can see that you are looking for a significantly narrower nasal appearance. The models that you have posted appear to be wearing a lot of makeup and contouring can allow somebody to achieve a narrower nasal appearance. That said, you appear to have an underprojected nasal tip appearance and I agree that your bridge is persistently wide. The issue with achieving a lot of nostril narrowing is that sometimes the scars are not worth the effort. Consider meeting with several reputable rhinoplasty specialists who offer computer Imaging so you can see what to expect with revision surgery. Thank you for your question. Sincerely, Dr Joseph

Gary M. Horndeski, MD · Answer

You would need an open rhinoplasty and also defatting of the tip. All this work could not be done with a closed rhinoplasty. It would also be hard to achieve the desired look you have provided with a closed rhinoplasty.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Ronald J. Edelson, MD · Answer

Your nose could be done either open or closed. Alarplasty scars typically heal very well even in black rhinoplasties. I would do your case as a closed rhinoplasty

Mats Hagstrom, MD (license on probation) · Answer

Just about every rhinoplasty procedure can be accomplished through a closed rhinoplasty.
Plastic surgeons will have different preferences, primarily based on how they were trained, their personal experience and personal philosophy.
It is technically easier to perform many detailed procedures with an open rhinoplasty, since it gives better visual Access.
That is the primary advantage to doing an open procedure.
The disadvantage is the incision across the columella.
I suggest having multiple in person consultations with plastic surgeons in your community to see what each one has to say.
You can ask about their experience and preference in regarding to open versus close. Try to plasty during the consultation.
Some plastic surgeons , use both open and closed approaches, depending on the case.
Look for senior plastic surgeons who focus either exclusively on rhinoplasty surgery, or those who have rhinoplasty as one of their more common procedures they perform.Look for providers, who have at least one to two decades of experience.
During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients, who had similar characteristics to your own, including similar skin color.
 an experience provider should have no difficulty showing you the before and after pictures of at least 50 previous cases.
Being shown a handful of pre-selected images, representing only the best results of a providers career may be insufficient to get a clear understanding of what average results look like in the hands of each provider.
Take care notes during each consultation, especially regarding the quantity and quality of before and after pictures.
 There’s no correct number of consultations needed to find the right provider.
The more consultations you scheduled the more likely you are to find the best provider for your needs.
Asking questions on this website probably is not nearly as helpful as beginning the process of vetting providers and having in person consultations.
Best,
Mats Hagstrom, MD

Closed rhinoplasty if I need alarplasty/ tip plasty & what exactly needs done to achieve desired results? (Photos)

Answers (4)

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