Can a Nostril Wedge Excision Be Performed on my Nose?

Hi there, I had an open rhinoplasty about 1 month ago now. Bulbous tip reduced, tip rotated upward and Alar base reduced with a Sill excision. After removing the cast I noticed my nostrils still retained the flare they had before the surgery, granted my nostrils were smaller they retained the same flared shape. He said a Wedge excision could not be done on my nose because of the way my nostrils inserted into my face (my nose lacked a nostril overhang he said). Is he correct?

Doctor Answers 18

Nostril Wedge Excision/Resection Will Likely Reduce Breathing Through Your Nose

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Thank you for your question. I agree that you should wait a year before considering revision Rhinoplasty.


That said, your result so far looks excellent and you are still swollen.


My concern about further wedge excision of your nostril base is that it will reduce air flow through the nostrils and create difficulty with nasal breathing. Be very cautious. Consult your Plastic surgeon, he has done a good job so far.

Alar base nasal revision surgery

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Your appearance is excellent, especially for one month.

It appears that in addition to the open rhinoplasty incision you may already have incisions at the alar bases that are healed.

Patients who chase perfection will end up with a lot of surgeries and not much perfection.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 195 reviews

Timing for Nasal base resection

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At one month it is very difficult, if not impossible to make any assessment of the final shape of the nose. It appears that you are off to a good start. I would recommend waiting one year and if you still have concerns then peform a simple procedure in the office. Assymetries are common at one month. They will often balance out as the swelling resolves. If you reach the year mark and the left nostril still flares a little. The weirs procedure could be performed on just that side. Hang in there.

Brian Maloney, MD, FACS
Atlanta Facial Plastic Surgeon
4.6 out of 5 stars 35 reviews

Nostril Wedge Excision

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It's only been 1 month since your surgery - you know swelling is present. If you want, reconsider alar base narrowing with your surgeon after you see the final result.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Alar base reduction by wedge resections.

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A decision to reduce the nostrils is based on the width of the eyes.From these pictures it is hard to make the comparison.SInce it is very early after the surgery I'll give it about 6 months to recover from surgery and if the alar base remains wider than the palpebral aperture width I'll consider resection.

Erel Laufer, MD
Dunedin Plastic Surgeon
4.7 out of 5 stars 35 reviews

Too hard to tell from these photos

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A very important aspect ot consider when narrowing the nostrils is the width of your eyes and the distance between your eyes.  Without those to see it is hard to tell.  In general a wedge excision can be done with very inconspicuous scars left behind.

Farzad R. Nahai, MD
Atlanta Plastic Surgeon

Wedge resection

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1 month is too soon to tell what your final nasal shape will be. I'd give it a little time before you rush in to another surgery.  It will take a few months before you will see the final result. Continue to see your rhinoplasty surgeon.  After 6 mo - 1yr passes and you still feel that your ala are too big, you can have another discussion with him/her about doing a small wedge resection.  

Dr. Cat Begovic M.D.

Nostril Flare Reduction With Wedge Resections As A Secondary Rhinoplasty Revision

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Further alar reduction can be done but at the 'price' of potentially more visible scars at the alar base. I would give what appears to be a good early result much more time to heal and you adjust to the new nose look. If the amount of alar flare is still bothersome at 6 months after surgery, then you should discuss with your plastic surgeon the adviseability of further alar base modification.

Can a Nostril Wedge Excision Be Performed on my Nose?

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Yes, a wedge excision can be performed, but I think it is prudent for you to allow more healing to take place before pursuing this. Also keep in mind that, from the frontal view, there is a balance between the width of the nasal tip and width of the ala. If you reduce the ala too much it may make your nasal tip look less refined. Things to keep in mind.

Anand D. Patel, MD
Brookfield Facial Plastic Surgeon
5.0 out of 5 stars 22 reviews

Repeat wedge excision on nostril PHOTOS

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The wedge excision could be performed but the angle that your nostril forms with your cheek/lip will make the incision more visible. You could benefit from an alar cinching suture to bring the soft tissues of the base closer together.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.