My nose flares giving a bulbous appearance, especially when I smile. What can be done? (photos)

Question

I am not sure whether a rhinoplasty is necessary. Honestly, I would like to avoid general anesthesia. Are there other ways of preventing the nose from appearing so bulbous?

Michael Zacharia, MBBS, FRACS, FAAFPS · Answer

An alar base reduction would address the nasal flare but you also have a hanging columella (the bottom middle of your nose that joins the space to your top lip).  Rhinoplasty means surgery of the nose and this is what is required in your case, but only the tip.  Many people have nasal flare but some are more prominent than others, expecially if you have a large tip.  I would suggest alar base reduction and refinement of the tip of your nose to give your nose a better shape and bring the base of the nose into more symmetry with the bridge.

William Townley, MD, FRCS(Plast) · Answer

Thank you for your question. The desired appearance of the nose is very individual and person-specific. There are many different techniques available that can be used to achieve a specific look. The consultation process is therefore so important - to tease out exactly what you are looking for and to discuss safe and suitable options in full. For example, if it is the width of the nostrils (flaring) that is bothersome, an alar base reduction can be performed potentially under local anaesthetic. Whereas, if it is the bulbous tip that troubles you, then a tip rhinoplasty (open or closed - confusing terms as they both involve incisions) can narrow the tip region and  improve tip definition - my preference is for general anaesthetic in these cases. Good luck.

Tanveer Janjua, MD · Answer

Alarplasty under local anesthesia will give you the improvement you desire with width of the nostrils especially on smiling. Watch the video link to see the actual procedure. RegardsDr. J

Joseph Shvidler, MD · Answer

First of I wanted to say that I think you have nice nasal profile! Narrowing the tip is tricky without compromising projection of the tip. An alar-plasty can help and can be done under local anesthesia. I would also note that your bridge is very narrow which gives an illusion of a wide tip. So balancing the width of the bridge would also help. Finally I would caution about taking selfies with smart phones and point and click cameras, as they tend to magnify central facial features. Take a professional photo and see if you notice a difference!Good Luck!Dr. Joe

William Portuese, MD · Answer

The rhinoplasty procedure is performed  to narrow the nose at rest, not upon smiling. To narrow the bulbous tip, suture techniques are applied to the lower lateral cartilages. To narrow wide nostrils,  an alar- plasty is performed. When performing a full rhinoplasty in our practice, we place patients under general anesthesia for comfort and safety. An alar plasty can be performed under simply local anesthesia. For more information and many examples, please see the link and video below

Steven Wallach, MD · Answer

All noses flare a bit with smiling. If you are unhappy withthe tip in terms ot its width, that is another story. Best to be seen in person to properly evaluate you.

Michael L. Schwartz, MD · Answer

You will have to have some form of surgery if you want to reduce your nose. Although I could not say for sure without actual exam it does appear from the photos posted that you could have a tip only rhinoplasty which is easily accomplished under local anesthesia either alone or with some IV sedation.

Richard W. Fleming, MD (retired) · Answer

Your nasal tip and the base of your nose can be narrowed.  Sedation can be used rather than general anesthesia for this limited procedure.

Francis R. Palmer, III, MD (retired) · Answer

It does appear that you have a full, wide tip.  A tipplasty would benefit you to reduce and refine your nose.  The incisions are made on the inside of the nose and no one will see them.  I would suggest having a bit of IV sedation for this procedure.

My nose flares giving a bulbous appearance, especially when I smile. What can be done? (photos)

Answers (9)

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