Nose is wide and disproportionate to my face. Would I be a good candidate for alarplasty? (Photos)

Question

I am considering surgical options to reduce the width of my nose as it is extremely wide and disproportionate to my face. alarplasty keeps coming up as an efficient method, but I feel that although my nose is wide, my nostrils aren’t exactly huge. Could I have functional problems after alarplasty?

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.
As far as I can understand from your question if your nostrils are normal in size, the perceived width comes from a wide bony bridge, weak tip support, or flared lower lateral cartilages. Performing an isolated alarplasty in this scenario over-constricts the nostril aperture and compromises the airway. To safely narrow a wide nose while protecting your breathing, a structural rhinoplasty&mdash;utilizing osteotomies to narrow the bony base and tip restructuring with autologous grafts&mdash;is required rather than cutting into normal nostrils.
Best Regards!

Semih Yildiz, MD, FEBOPRAS · Answer

In my experience, the two photos suggest width at the alar base, but photos cannot show nasal airflow, internal valve anatomy, skin thickness, or how much width comes from the dorsum or tip versus the nostril margins. Alarplasty narrows the nostril base but does not narrow the entire nose; if too much is removed or support is not preserved, it can cause asymmetry, visible scars, notching, or breathing obstruction. A consultation should assess front, profile, oblique, and basal views and evaluate the septum, turbinates, and nasal valves. If overall width is the concern, tip or dorsal work may be needed instead of, or in addition to, alar reduction. Discuss conservative options and functional risks with an experienced rhinoplasty surgeon.

Zachary Farhood, MD · Answer

I would not touch your nose.  It appears well proportioned and not wide. Alarplasty can certainly have functional issues and is irreversible. Tread lightly.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you may benefit from a rhinoplasty. A surgeon can accomplish this by trimming, suturing, and reshaping the cartilage in your lower nose. Fascial grafts may also be used to help improve tip refinement. Make sure you are going to a surgeon with hundreds of long-term before and after pictures on their website with standardized lighting and standardized backgrounds. 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. FACS
Harvard-trained board certified plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D. FACS
Harvard-trained board certified plastic surgeon

Gary M. Horndeski, MD · Answer

Looking at the view from the base, your nose should be an equal triangle. As you can see, it is very wide at the base with very little projection. You may benefit from having augmentation of the tip to increase the projection. This will increase the nostril size. You would also benefit from decreasing the width of the columella by pulling the medial crura together. This will open the airway even more.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Zoran Potparic, MD · Answer

It would take more than two photos to decide whether changing the thickness of the nostrils is the way to improve nasal base in your case. Anyway, alloplasty can be done using wedge excision of the base of the alla, just above the groove, without changing the size or shape of the nostril. In person consultation with an experienced board certified plastic surgeon would help. Good luck.

Tanveer Janjua, MD · Answer

It is important to know that alarplasty is not just for reducing the width of nostrils but also for subtle changes like the shape or orientation of the nostrils. In your case width is not as much of an issue as the slight flare and the actual thickness of the alar wall. You would benefit from both a mild width reduction but more importantly reduction of the alar wall thickness. Both can be done at the same time. It is more common in my Asian patients. They usually have less width issue and more of a wall thickness issue. 
Regards
Dr. Janjua

Mert Demirel, MD · Answer

Alarplasty can reduce nostril flare or the width of the nostril base, but it only addresses the lower part of the nose. If the main width comes from the bridge, nasal bones, thick skin, or a broad tip, alarplasty alone may not give the balanced narrowing you want.
You are right to be cautious. If the nostrils are not actually very large, removing too much from the alar base can make the nostrils look small, tight, or unnatural. It can also create breathing issues if the nostril opening is narrowed too much or if there is already internal nasal valve weakness.
For a wide nose, the best plan may involve a more complete rhinoplasty assessment: narrowing the bridge if needed, refining the tip, improving support, and only doing alar base reduction if the nostril base is truly contributing to the width. Sometimes a small alarplasty is helpful, but it should not be used as a shortcut for every wide nose.
I would recommend asking your surgeon whether your width is mainly from the nasal bones, tip, nostril base, or skin thickness. If the nostril size is already reasonable, conservative tip/bridge refinement may be safer than aggressive alar reduction. The goal should be better proportion while preserving natural nostril shape and normal breathing.

Nose is wide and disproportionate to my face. Would I be a good candidate for alarplasty? (Photos)

Answers (8)

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