Nostrils very wide with smiling 5 years after rhinoplasty - what can I do? (photos)

Question

I am 5 years post op rhinoplasty and ever since rhinoplasty I noticed my nostrils got wider, but effectively double in size and expand and bow out upon smiling. I did not have this problem before rhinoplasty. I *did* go to my surgeon, twice, for not one but two followup alar base reductions, which only improved my nostrils at rest. My nose was only deprojected a very tiny bit, and all my surgeon says is that “I have a big smile,” which I know it can’t be the only issue.

Gianfranco Frojo, MD · Answer

From just this view it is difficult to fully understand what is potentially a very complex analysis to perform. It may be that you had too narrow of nostrils prior to surgery and the widening was required to ensure you had adequate airflow after. I would highly recommend seeing a board eligible or board certified plastic surgeon for a physical exam and accurate analysis with safe recommendations for potential surgical options. Best of luck!

Tanveer Janjua, MD · Answer

Your smile is indeed big but keep smiling. At this time more nasal sill reduction can be done with some more alar reduction. However, you risk breathing issues. You have to weigh the risks and benefits and proceed. I have had patients who said they don't care about nasal breathing being reduced but want nostrils narrowed. But not all patients feel that way. So give it some thought and smile!
Best regards
Dr. J

Robert Ciardullo, MD · Answer

Wide nostrils when smiling: everyone’s nostrils flare a bit when they smile. The bigger the smile, the more the flare. It appears that at rest your nostrils are quite thin. If the nostrils are made to thin there may result a breathing difficulty, so I would not push the issue any further since if your nostrils Are made thin while smiling they’ll virtually close when not smiling, especially on inspiration.

Jeffrey C. Hamm, MD - Account Suspended · Answer

Hi and welcome to our forum!
In repose, your nose appears normal. With a smile, however, nostril flare is noted. 
Triangular (Weir) excisions at the nostril base are used to correct "static" nostril flaring in repose). Nostril flare with excessive "dynamic" expression can often be treated with periodic injections of botox.
Best wishes...

Nostrils very wide with smiling 5 years after rhinoplasty - what can I do? (photos)

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