Flaring and droopy tip when I smile - would a nostril reduction surgery or weir excision give me good results? (Photo)

Hello and thank you for your question. Based on your photograph, you are a great candidate for a revision rhinoplasty. Maneuvers for your surgery would include tip refinement, tip support, tip elevation, among other maneuvers. I would not recommend external alar base incisions. 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

Alarplasty will reduce your nasal flare easily. For the droopy tip you will need more evaluation to figure out the cause. It could a muscle pulling it down, too much columella. With the horizontal crease on the upper lip it is likely that you have a strong nasal depressor septi muscle. A little Botox in that area can confirm that. If not then a tip graft can help.
Regards
Dr. Janjua