Caucasian Alar Base Reduction? (Photo)

Question

Hi all, I have had two rhinoplasties that deprojected my nose. As a result my nose appears to be wider. In your medical experience, should alar base reduction or an alternative method (cephalic trimming, cartilage grafting, or simply no action) be pursued? Thanks for your advice.

Andrew Miller, MD · Answer

When a tip is deprojected, it can look wider if it is not defined as much as possible. But you can't always fix it by reducing the nostrils. The tip is a naturally triangular shape, and since your tip is still wide, if you just bring in the nostrils, it might make the nose look more boxy. It might be possible to improve the appearance of the alar flare by bringing in the nostrils some, but you may also need the tip a bit thinner too. These are the questions that can be answered by an experienced rhinoplasty surgeon at consultation.

John Layke, DO, FACS · Answer

manhattanGurl,It would be helpful to know how long ago you underwent a rhinoplasty.  It appears that you still have a moderate amount of swelling which will change for up to one year after surgery.  Although I haven't seen your before/after profile view, it appeared that you needed to remove a small hump and narrow the tip of your nose.  It now appears that you may have lost tip support, creating a wider-appearing nose.  Alar base reduction can always be performed after a rhinoplasty, but it is important to know exactly what was done in order to determine the best plan of action for you.  Relay your concerns to your surgeon who will reassure you and determine the best course.  Best wishes!

Steven Wallach, MD · Answer

It is difficult to say what would be best for you without a good exam in person. The photos are not very helpful

William B. Rosenblatt, MD · Answer

Thanks for your question, but with those photos, I can't tell. You would need an in person consultation so I could see and feel your nose.

Jarrod Little, MD · Answer

Alar base reduction makes sense, in order to decrease nasal width.  However, it often leaves scars that can be noticable.  These scars often require revision.  The long-term results of alar base reduction is very variable.  Many patients do not show a durable result in reduction, if followed over time.  It is difficult to say whether another method would be available, without knowing exactly what was done in your first two procedures.  This would require a physical exam and review of the previous operative reports.  As always, it is important to personally consult with a board-certified Plastic Surgeon who has a particular interest in rhinoplasty.

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