I would like to reduce alar sidewall and correct deviated nasal tip/septum, but is alar sidewall reduction possible? (photos)

I am a 28 year old female in pretty good health and with no prior h/o surgeries. My main concerns are a deviated nasal tip and/or septum (which displaces my nose toward the left) and asymmetrical thickness of my alar sidewalls, the right being much thicker/larger than the left. As I do have a slight dorsal hump, but with no desire to reduce it, can surgery address my concerns without affecting my dorsal hump? Also, is reducing alar sidewall thickness possible? Thanks in advance.

Doctor Answers 6

Alar Sidewall Reduction (Alarplasty)

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Alar side wall reduction can be done without touching the dorsal hump. The septoplasty can be done at the same time. Straightening the nose might involve osteotomies (breaking the bones) but it can be done without removing the dorsal hump. 
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.

Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 126 reviews

I would like to reduce alar sidewall and correct deviated nasal tip/septum, but is alar sidewall reduction possible?

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I do not believe for requests being sooo specific, there can be achieved to your liking. In my over the internet opinion you need a septalo/rhinoplasty. Which does evlove your dorsal hump reduction... Best to seek ONLY IN PERSON opinions... 

Septal issue? Dorsum

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I think that you need to be seen in person to be properly evaluated.  A septal deviation if significant and potentially causing breathing problems is usually worth correcting. Hard to tell from photos. Minor side wall asymmetries probably are not worth the attempt to try to make it better because they seem to be within normal limits.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Big picture vs. Minutia in #rhinoplasty

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Overall you have a very decent nose.  You cannot make the two sides perfectly symmetric and at least based on these preliminary low resolution pictures, your nose is as symmetric as possible.  If you don't want to reduce the small hump, or you dont want to make the tip smaller or lift it up slightly then I would leave it alone.  You are chasing minutia and missing the big picture if you decide to pursue what seems to bother you in this case rather than what is aesthetically desirable in general.  

Alar sidewall reductions are possible and can be made but most often the skin thickness is different from side to side as is the area where each nostril attaches to the cheeks (face).  Those cannot be changed.  

If your septum is deviated and you cant breath then a septoplasty should help with that.  You need to go to a specialist and have him or her examine you and do computer imaging and show you what may be possible.  

Shervin Naderi, MD, FACS
Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 119 reviews

Septoplasty and Rhinoplasty candidate

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The septoplasty procedure is performed for medical necessity when there is a blockage of airflow due to obstructing cartilage and bone in the back of the nose. This procedure is billed to the patient's medical insurance once medical necessity has been documented after examination and consultation.
The rhinoplasty procedure can address the twisted tip and narrow the nasal tip cartilages. An alar platy  can narrow wide nostrils. The hump on the nose can certainly be left alone if it's your personal desire. A septoplasty and a rhinoplasty can be performed together under one anesthetic
For many examples, please see the link below to our rhinoplasty photo gallery

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Tip asymmetry

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An adroit plastic surgeon should be able to achieve a symmetric result for your tip.
There are a number of techniques that can be used to get the result you look for.
Make sure you go to an experienced rhinoplasty surgeon.
Good luck.

Marcelo Ghersi, MD
Miami Plastic Surgeon
5.0 out of 5 stars 154 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.