Nostrils Are Too Wide, Tip Too Flat, How Can It Be Fixed? (photo)

Thank you very much for the questions.The harmony between facial parts makes us instinctively recognize the beauty... without knowing it, without defining it, just a perception that surprises and captivates us.In this regard, After having analyzed all the info. and photos provided to us, i recommend you perform an Open Full Rhinoplasty, includding narrowing of the nasal base and nostrils, with nasal bones treatment (controled fracture) and alar + triangular nasal cartilages re-shaping.With this procedure you get a delicate nose, better harmonize with your other facial features.Respectfully, Dr. Emmanuel Mallol.-

Hello Blondie B.,

Thanks for your question.  Your questions and concerns are very common for African Americans seeking rhinoplasty.  It is possible to reduce the size of and change the shape of your nostrils, while at the same time improving the shape and projection of your nasal tip.  Changes when one smiles in the nasal tip can be overpronounced, so this concern of yours is valid.  This too can be blunted to reduce it's effect.  Procedures such as alarplasty (nostril reduction) and tip reduction/grafting with columellar strut graft placement can improve and balance the features of your nose.  Asymmetric nostrils are more difficult to fix because they are often the result of other facial asymmetries that are very difficult and expensive to fix.  A question that I ask all of my patients of color seeking rhinoplasty is "is keeping your ethnicity important to you?"  If the answer is "yes" then you must be careful to avoid getting an over-sculpted look (like Michael Jackson.)  If the answer is "no" than aggressiveness is warranted but carries with it greater risk.  Make sure you consult with a specialist in Ethnic rhinoplasty to come up with a reasonable surgical plan.

Good luck,

Dr. Shah

The width of the nostrils can be reduced with an alar base reduction, or "alarplasty." The nostrils can also be made more symmetric with cartilage grafts. There are also ways to refine the nasal tip, and eliminate a "flat" appearance as you describe. Specifically, the following grafts may help:

1) Alar rim graft: helps prevent pinched nostrils and improve shape of the nostrils
2) Shield graft: used to project and define the nasal tip
3) Columellar strut: used for support and straighten the nasal tip.  It can also be used to increase projection
4) Composite graft: helps improve the appearance of receding nostrils

A detailed exam would be necessary to give you the best advice and determine what you may benefit from. I would recommend an in-person consult with a board certified rhinoplasty surgeon. They will be able to evaluate your nose in person and give you suggestions. I hope this helps, and best of luck.

    The tip can be built up to add projection and make the tip appear more narrow.  In addition, the nostril width can be reduced as well.   Find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties and rhinoplasty revisions each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.

Kenneth Hughes, MD Los Angeles, CA

Alar base reduction can be used to narrow wide nostrils. You can check out my web reference link below to read more about this.

To improve your flat tip an increase in projection would be needed. An added benefit of making your tip less flat is that it would also make your nose look narrower on frontal view.There are several rhinoplasty techniques that can be used to improve your tip projection.