Is it possible to refine my tip and alar base without a “done” look? (photos)

I agree that you appear to have very thick skin, but without a physical exam and seeing your whole face in relation to your nose, it is hard to give you a surgical plan or comment on what should occur in your specific case. To help you, though, I can answer this question in broad strokes. Theoretically, it is possibly (depending on the surgeon and level of experience) to operate on someone with thick skin, addressing only the width of the nose without affecting the profile view. However, any alar surgery that decreases nostril width will leave you with incisions in the creases of your nose, where the nostrils meet your cheeks. Some skin types, no matter how fine the suture material used and how expertly sews, can show this incisional line in certain light. My practice mantra is “less is more,” which is increased for male patients, and all patients should never look like they have had surgery. I recommend you consult in person with a board certified plastic surgeon who has extensive experience with rhinoplasty. Always look up the surgeon’s before and after pictures. It is also a good idea to bring with you pictures of noses you admire to better communicate with your surgeon what your goals are.

Only on the basis of in person evaluation an experienced rhinoplasty surgeon can give you best options to improve appearance of the areas of concern. Consultation with a board certified plastic surgeon, expert in rhinoplasty is recommended. Good luck.

Thanks for your question and detailed concerns. It is possible to reduce nostril size, and refine a tip without having an overly "done" appearance. In fact, it is more difficult to achieve that look in thick skinned patients in general. At least 25% of the rhinoplasty result is based on treatment after the surgery and requires taping and one or more injection of a steroid combination. I would highly recommend that you seek a "closed" rhinoplasty. It is difficult to give you specifics as your pictures are limited by the number of angles and the green boxes. For more specific information for you, full face pictures (to see how your nose sits in proportion to your face) and more angles (3/4 view, helicopter view, and a waters view) would be helpful. It doesn't sound like what you are looking for is unreasonable at all though. Good luck!