Everything is in the nose for a reason. Planning the rhinoplasty should take into account the relative size of each anatomical part, its proportion, and its function. You should expect to breath at least as well--and often better--after rhinoplasty. Preserving the nasal airway is the surgeon's most important job. The supports to the airways are well researched and well known and an experienced surgeon can help you. Find a surgeon whom you trust and who can show you results in noses like yours that you like. Then you can proceed confidently.
The Rhinoplasty procedure can narrow the bulbous tip with suture techniques to the lower lateral cartilages, and sometimes a conservative cartilage removal. The alar plasty procedure involves removal of a small wedge of skin at the base of the nostrils to narrow the nostrils themselves. An experienced rhinoplasty surgeon can minimize the risks for nasal obstruction.
The tip and alar base can be reduced without compromising breathing.
Kenneth Hughes, MD
Los Angeles, CA
Unless nostril narrowing is overdone, it does not cause impairment in nasal breathing. There are other aspects of a rhinoplasty that may and these are more important to look out for than that of nostril narrowing alone.
Alar base reduction or nostril narrowing by itself usually does not considerably effect breathing. In the short-term swelling from any nasal surgery will cause some congestion. Tip narrowing is more likely to cause long term problems with your nasal breathing if it is overly narrowed. Consult with a board-certified surgeon who has extensive experience in rhinoplasty surgery.
Breathing is usually NOT an issue with alar reduction and tip rhinoplasty. But you need to come to terms with this. Best to discuss with your surgeon again...
If the procedure is done by an experienced surgeon you can refine the tip and reduce the flared nostrils without compromising your airway. Surgery is not analogous to just manipulating the nose when no tissue is removed or surgically repositioned.
A well executed alar base reduction will not result in airway collapse. Looking at your tip, refining techniques would help improve the bulbous round appearance which would be aesthetically pleasing. Visit with an American board of plastic surgery surgeon or a facial plastic surgeon for best results.
Conservative alar base modification will not impair your breathing. Seeking out a rhinoplasty specialist who respects the structure of your nose, and knows how to maintain its proper function is important in achieving a successful result.