Will an alar rim graft be able to fix my tall nostrils? (Photos)

the part of my nostrils closest to the tip of my nose is a bit tall, giving it the appearance that my nose is pinched. its similar to the photos. will an alar rim graft be able to lower it a bit? is there anything in the way (like cartilage) that will prevent a surgeon to be able to fix it?

Doctor Answers 5

Alar rim graft for nostril retraction?

Your photo suggests to me that you will need more than a simple alar rim cartilage graft and instead a composite graft taken from the ear containing both cartilage and skin.  This should be confirmed on a face-to-face physical examination.
Thank you for your question.
Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
ABC-TV Extreme Makeover Surgeon
Beverly Hills, California


Beverly Hills Plastic Surgeon
5.0 out of 5 stars 30 reviews

Repair of tall nostrils

It is impossible to give recommendation on a very difficult surgical procedure without an in-person examination and a full set of facial and nasal photographs.  Alar rim grafts help stabilize the alar rim from collapsing with inspiration.  A composite skin graft( composed of skin and cartilage) is used to bring alar notching downward as in the photographs.  Some patients need a reduction of the hanging columella, also shown in the photographs.  For more information  and many examples from our practice, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 reviews

Alar Rim Graft

Alar rim grafts consisting or cartilage or cartilage and skin can be placed to lower your nostril rim. Nothing will be "in the way"; in fact the problem is cased by a retraction or lack of cartilage in this area.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Alar rim graft

Your nose needs more than the nostrils corrected. I prefer to use a composite(skin/cartilage) graft from the ear.It also appears that you need dorsal grafting and tip grafting. This can come from septal cartilage.A chin implant may also be in order.

Dennis Barek, MD
Great Neck Plastic Surgeon
5.0 out of 5 stars 6 reviews

How to fix alar retraction

Thanks for your question. There are a couple of ways to fix alar retraction. The choice of technique depends on the relation of other structures to the alar rim. Alar rim grafts are a classic way of fixing this. You create a pocket in the skin along the alar rim and slide a thin piece of cartilage into it. The pictures you attached seem like classic examples of this technique. Other techniques can be used but it all depends on what else is happening with your nose. Good luck!

Robert S. Schmidt, MD
College Station Facial Plastic Surgeon
5.0 out of 5 stars 7 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.