Never seen a nose like mine; is it possible to fix it? (Photos)

Question

Is it possible to make the nostrils smaller with it still looking natural? It's easier to take something away than to add something and it seems like you would need to ADD skin/cartilage and is it possible?

Matthew Bridges, MD, FACS · Answer

Based on your photos, it appears that you have a "hanging columella".  This is usually excessive septal cartilage that pushes the columella, or the cartilage/skin between the nostrils, down. You also may have slight nostril arching, exacerbating the issue on profile.  These issues can be improved with rhinoplasty.  You might consider having someone perform digital "morphing" to show you what might be possible with surgery.

James C. Marotta, MD · Answer

I have seen plenty of noses like yours :)!  What you are calling too much nostril is called a hanging columella or excessive columellar show.  You also have alar notching because of weakness of the cartilages that make up the tip of the nose.  There are several maneuvers that can help this problem.  Trimming of the caudal septum, removing some of the lining inside the nose, and grafting of cartilage to the weaker portion of the tip, and sometimes even composite grafting.   What would help most is a thorough exam and consultation to discuss your options.

Eric M. Joseph, MD · Answer

Your columella appears to hang on profile view, and this excessive nostril show may be addressed during rhinoplasty surgery, depending on your examination. Hope this helps you. Dr Joseph

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your
photograph, you may benefit from alar batten grafts to help reduce your alar flare. The most important
aspect is to find a surgeon you are comfortable with. I recommend that you seek
consultation with a qualified board-certified plastic surgeon who can evaluate
you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Samir Undavia, MD · Answer

Yes, it's possible to decrease your nostril size. From the two pictures you submitted, I think decreasing the "columellar show" ( the skin in between the nostrils is hanging down) would help you the most. Yes you could elongate the nostril edge but that is much more difficult than pulling up the columella. I think you would have a great result and be very happy with that kind of rhinoplasty.

Richard Mark Winters, MD · Answer

you do, in fact have nostril show.... this can be caused by a 'hanging columella,' retracted nostrils or a combination of the two.... you columellar/philthral column angle (between your nose and upper lip) is close to ideal for a woman... although your columella could be moved up a bit by a variety of surgical techniques, it will also imperative to lower your alar rims as wellYour tip is a bit boxy in that your tip cartilages have what's called a wide angle of divergence and the footplates flare a bit... refining your tip appears fairly straightforward and would round off your nostrils and make them slightly less elongated without any type of nostril incisionMake sure to visit a few surgeons and get a thorough evaluation and surgical plan....the best chance to get it right is the first time...Good luck....

Steven Wallach, MD · Answer

You might have a hanging columella which can often be treated by trimming the caudal septum. It may also be flaring of the nostrils that may respond to grafts but the alar will be thicker.

William B. Rosenblatt, MD · Answer

Im not sure what is wrong with your nostrils -- they look normal to me. I would not put grafts in them - it would just make them thicker. Let an experienced rhinoplastic surgeon evaluate you in person.

James Fernau, MD, FACS - Account Suspended · Answer

Thank you for your question and photographs.It appears that you have a hanging columella and enlarged nostrils. This can often be treated by trimming the caudal septum and making an incision on the inside or outside of the nostrils then removing a specific amount of tissue to reduce the size and/or make more symmetrical. I recommend that you schedule a consultation with a board certified plastic surgeon who specializes in rhinoplasty to have a nasal examination performed and a review of your medical history to see if you are a good candidate for these procedures. Best of luck in your endeavors.Sincerely,

James Fernau, MD, FACSBoard Certified ENTBoard Certified Plastic SurgeryMember of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS, International Federation for Adipose Therapeutics & Science

James Fernau, MD, FACSBoard Certified ENTBoard Certified Plastic SurgeryMember of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS, International Federation for Adipose Therapeutics & Science

Richard W. Fleming, MD (retired) · Answer

With the limited pictures you submitted I suggest you have your surgeon lift the  columella (the strip between your nostrils) , possibly add cartilage to lower your arched nostril rim,  and refine and narrow the tip  which will address the concerns you've described.

Never seen a nose like mine; is it possible to fix it? (Photos)

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