Is it possible to lower my alar/raise nose tip? (Photo)

Question

Possible to do surgery on alar and or nose tip without touching bridge? I’d like to either raise the tip of my nose and or lower the alar. My nose is ok at rest but when i scrunch my nose or smile my alar/nostrils lift up dramatically which creates an unsightly snarl appearance. I have had a rhinoplasty in the past, have been quoted a revision for $25k which is completely out of my budget and seems to invasive

Tanveer Janjua, MD · Answer

The nostrils are pulled down and inwards with Alarplasty and the flare on smiling is reduced. 
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 mimick 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.
Regards
Dr. J

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photograph, it is possible to elevate and support your tip, while lowering the amount of alar retraction. This is a very complex procedure and a full revision is absolutely needed for this type of result. Cost varies based on geographic region and surgeon expertise. With good surgical technique, you could have an outstanding result. 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

Is it possible to lower my alar/raise nose tip? (Photo)

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Is it possible to lower my alar/raise nose tip? (Photo)

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Our mission is to create a world where every investment in modern beauty is Worth It.