My nose flares a lot when I smile and not sure if alarplasty is the right option. Opinions? (photo)

Question

Went for a free consultation and was recommended this along with "sloping" the bridge of my nose. Would be interested in hearing your thoughts. My nose flares a lot when I smile so not sure how the flaring will change after this procedure. Another concern is that my nostrils and when they flare will be asymmetrical. Appreciate hearing your thoughts!

Stephen J. Pincus, MD · Answer

Without seeing a front view photograph, it is difficult to give a definite answer to your question. However, from similar cases, I have used a "cinching suture" beneath the nose to prevent excessive widening of the alar base when smiling. It is important to do a complete dissection and not just suture placement, to allow scar tissue to form to ensure the effect lasts. Also, because of the apparent obliquity of your nostril axis, I usually do some form of alarplasty to reduce the "snarling" appearance of the nostrils. Finally, you do appear to have a low dorsum, which may benefit from augmentation. However, this would almost certainly require increased tip support & projection, which would also benefit nostril positioning.

Jeffrey Lisiecki, MD · Answer

Alar base reshaping will reduce the flaring of your nostrils from excess skin, but not change anything else from your nose really. More views or an in-person examination, along with a closer discussion of your concerns, would help determine if you would be a candidate for alar surgery alone or a full rhinoplasty. Most patients are better served with a full rhinoplasty as their concerns would not be completely addressed through the more limited procedure.

Ronald J. Edelson, MD · Answer

You appear to be a good candidate for alarplasty.. just be aware that not all surgeons like doing alarplasties so you need to find a surgeon who does  them often

William Portuese, MD · Answer

A closed rhinoplasty approach can accomplish releasing the depressor septi ligament which pulls your tip Down dynamically when you smile. In addition, the procedure can also reduce your hanging columella , shave down the dorsal hump and reduce the dynamic widening when smiling as well. All the incisions are placed on the inside of the nose. An alar plasty is performed to narrow wide nostrils. A full set of facial photographs are required to make a determination about how best to proceed

My nose flares a lot when I smile and not sure if alarplasty is the right option. Opinions? (photo)

Answers (4)

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