What is my best surgical option for tip definition and alar reduction? (photo)

I would like tip definition and an alar reduction.  Are these reasonable requests and what sort of surgical technique could accomplish it? Please note that the tip of my nose is firm and caucasian like.

Doctor Answers 9

Refining a near perfect nose

I think that your nasal tip is already refined and one has to weigh the pros and cons of trying to refine a near perfect nose. 

On examination, the front view, your right nostril is not flared but the left flares out slightly are there is an asymmetry.  This could be addressed by an alar base reduction only on the left, removing a few mm. of skin.  The risk is a small scar along the side of your nostril.  Most people heal well esp. in Caucasians.  Some patients benefit from laser treatments post operatively to blend in the scar.  On your profile view, again, there is little change that is necessary.  If one were to examine things very closely, the tip of your nose could be projected a 1 to 2 mm more to give you more of what we call a "supra tip break".  By lifting the tip of the nose higher slightly, it will also narrow the nostrils slightly which would add to the tip refinement.  

A word of caution, anything more than small subtle changes in your case could give you an unnatural result.  We offer Vectra 3D computer imaging to our patients so they can see in a very realistic way how their results can look after surgery.  This may help you in your decision process.

Good luck. 

Manhattan Facial Plastic Surgeon
4.8 out of 5 stars 153 reviews

Tip Definition and Alar Reduction

You have a great nose.  I wouldn't do anything to try to give you more tip definition as you have good definition.  Your alar base is slightly wide.  If it bothers you, an alar base reduction would take care of this.  

Jonathan Pontell, MD, FACS
Philadelphia Facial Plastic Surgeon
4.8 out of 5 stars 103 reviews

You appear to have a nice nose. Proceed cautiously with rhinoplasty surgery.

I reviewed your photos and your concerns. I agree that your tip and nostrils are a bit wide with mild asymmetry on front view. Well performed rhinoplasty surgery may address these concerns, but as stated above, you don't have a distracting, large nose. You should reserve rhinoplasty surgery for extreme dissatisfaction with your nasal appearance.

You may benefit from consulting several reputable rhinoplasty specialists so you could make a decision that might be best for you.

Hope this helps you.

Dr. Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 418 reviews

Rhinoplasty for tip definition and alar reduction

An alar base reduction is accomplished by placing a small incision at the  floor of the nose and removing a small wedge of skin to narrow the nostril base. This can be performed as a stand-alone procedure under local anesthesia.
When the bulbous tip is present( not in this case) tip suturing techniques to the lower lateral cartilages are performed to narrow the shape of the tip and reduce the bulbousness.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Refining tip

Dear cornball1213,

Your tip looks relatively refined already.  I would be very careful about having tip surgery since the outcome is never guaranteed 100%.  Your could have a conservative alar base resection.  Make sure you are seeing someone with extensive experience in rhinoplasty. Good luck. 

Richard A. Bartlett, MD
Brookline Plastic Surgeon
5.0 out of 5 stars 11 reviews

Tip definition and wide nostrils

From your pictures it appears that you have thin skin and good tip contour. It would be risky to alter this tip because of the delicate nature of the underlying cartilages. When the skin is thin it tends not to adequately camouflage surgical imperfections in the underlying cartilage framework. This can lead to asymmetries and bossae formation. That said, you may be a candidate for alar resection. The incisions usually heal up nicely, however,there is typically a very fine residual suture line.

Geoffrey W. Tobias, MD, FACS
Englewood Facial Plastic Surgeon
4.5 out of 5 stars 51 reviews

Conservative Tip Rhinoplasty

Thank you for your question and for sharing your photos.  A very conservative tip rhinoplasty to enhance tip definition and projection would be beneficial.  I would caution against alar reduction because your proportions appear to be normal on the limited photos. Consult with an experienced Plastic Surgeon for further information on this procedure. All the best!

George Bitar, MD
Fairfax Plastic Surgeon
4.6 out of 5 stars 54 reviews

What is my best surgical option for tip definition and alar reduction?

Based on your photos, I do not think you are a candidate for Alar Reduction and Tip Definition.  Consult with a Board Certified Plastic Surgeon to confirm.

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 60 reviews

What is my best surgical option for tip definition and alar reduction?

I think your nose looks very good and surgery could only offer subtle improvement at best.  However, scarring and healing are not entirely predictable, so I may not offer any surgery at all.

Kenneth Hughes, MD

Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 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.