I like my nose but would like smaller nostrils - what can be done? (Photos)

Question

I like the side view of my nose but the front profile view of my face lacks definition.. would I need rhinoplasty as well since I have a flat bridge?

Peter Lee, MD, FACS · Answer

Because changing one aspect of your nose changes the proportions of the rest of the nose, we generally recommend to patients that the nose be approached wholistically.  In your case, your nostrils are somewhat wide, and this can be addressed by performing Weir excisions to move the lateral ala medially on either side, with the incisions hidden in the alar crease and inside the nostril.  But additionally, you have a low nasal dorsum that could be elevated by placing either a nasal implant, an autogenous cartilage graft from one of your own ribs, or sterilized cadaveric rib.  Your bulbous nasal tip, which is what makes you think your face lacks definition, could be refined by trimming and suturing the lower lateral nasal cartilages, and overlaying this with cartilage grafts from your nasal septum and conchal cartilage.  We would perform all of these maneuvers with an open rhinoplasty technique that allows us to expose the entire osseocartilaginous framework of the nose via an incision placed inside each of the nostrils and across the columella.  Most of this incision is invisible to the observer, and the small inverted v scar on the columella tends to heal quite inconspicuously.

Andrew Miller, MD · Answer

You could try filler to build the bridge and project the tip, but the best result would come from surgery. Ideally, the bridge would be built up to take away the washed out look from the front and the tip would be better projected to make it look less round. The nostrils can also be reduced in size. Be sure to see a rhinoplasty specialist for consultation.

Oakley Smith, MD, FRCSC · Answer

Yes it is possible to have rhinoplasty surgery to improve the definition of the tip and to decrease the flaring of the side walls to make the nostrils look smaller, while preserving the shape of bridge of your nose.

David M. Kowalczyk, MD, MBA, FACS · Answer

Good Morning! You can certainly change the width of your nostrils and not perform any rhinoplasty to change the shape of the rest of your nose. I refer to this as an alar base reduction. An incision is made on the underside of the nostril and a pre-determined amount of skin is removed. The wound is sutured and the results can be quite nice. If you want more definition on the front view, then further intervention in the form of a rhinoplasty would be needed. You could refine the tip and raise the bridge to create narrowness on the front view. Hope this helps!

Robert Ciardullo, MD · Answer

Are you a good candidate for a rhinoplasty?
You used the word “need“. Obviously, since this is cosmetic surgery no one “needs “ a Rhinoplasty. But, by the textbooks of aesthetics it appears that your bridge is wide, your tip is slightly bulbous, and your nostrils are wide. A standard Rhinoplasty would address these issues. It however your tip and bridge do not bother you and you only want to narrow the nostrils, there is a procedure called a nostril tuck which can be down under local anesthesia in the office. But if you wanted a thinner nose in the front view including the bridge and tip as well as the nostrils, then that would be achieved by a traditional rhinoplasty.

Akshay Sanan, MD, FACS · Answer

Dear Beautiful537213,
Thanks for posting your photos. In order to achieve smaller nostrils, that requires alar base reduction surgery. A small incision is made in the crease of where your nostril meets your cheek and the excess nostril is removed surgically. You have a nice side profile view of your nose. I agree that your front profile view lacks definition. In order to improve this, the tip cartilages need to be restructured and reshaped. This requires using cartilage from your septum to add support to your tip cartilages and to reshape them with advanced suturing techniques. I hope this helps answer your question, if you'd like to talk further I encourage a consultation with a board certified facial plastic surgeon.
All the best,Dr. Sanan, MDFacial Plastic SurgeryLos Angeles, CA

Jeffrey C. Hamm, MD - Account Suspended · Answer

Hi and welcome to our forum!
From your photos, I note that you appear to demonstrate a slightly broadened nasal base, a slightly high bridge, a slight tip droop, a rounded amorphous tip, a flare of the nostrils,  and a lack of tip projection.
If the nostril flare is your concern, a tip rhinoplasty with Weir excisions will eliminate the flare and define the nasal tip. The tip can be rotated upward to eliminate the droop.
If you wish a more dramatic change, lowering and narrowing the bridge to create a gentle feminine curve can also be performed with a complete rhinoplasty.
Visit a board certified plastic surgeon for evaluation and discussion.
Best wishes...

I like my nose but would like smaller nostrils - what can be done? (Photos)

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