East Asian, female, and have pretty thick scar-prone and oily skin. Are my alarplasty expectations reasonable? (Photos)

Question

Hi doctors, I'd like to know if my expectations are reasonable! I am of East Asian ancestry, female, and have pretty thick scar-prone and oily skin. I really love my natural nose, it's quite bulbous at the tip but I like the look of bulbous noses. It's also very small naturally, so I want to emphasize that I DO NOT want significant alar reduction. I have fleshy, droopy nose wings that fall below my columella, which means that in a 3/4 perspective my other nose wing is still visible. I've drawn lots of examples to better show what I mean. Some questions I have for doctors who are well versed in this procedure: 1. Do you commonly receive patients with asymmetrical alar flare, and how do you measure symmetry before the procedure? 2. Are visual results different between patients with thick skin like mine and those with more malleable, thin skin? 3. Is it possible to achieve my expectations without triangular nostrils?

Lexie Wang, MD · Answer

We're missing a key view, which is the base view, to really assess. But based on what you are saying -- I think you'd be considering Weir excisions only and only a subtle amount to decrease how much of the "wing" (flare) you see without bringing in the nostrils physically (causing the triangle shape/etc. that you have in one of your pics). HOWEVER, you should also know that you can't change the fact that one nostril attaches higher on teh face than the other, which your first photo seems to attempt to try to fix -- the left one will always be lower.

Tanveer Janjua, MD · Answer

I have a lot of Asian patients.  Asian skin is not as sebaceous which makes the healing easier. Find refinements like you are asking for are pretty common. 
Yes, you can have alarplasty without getting a triangular or pyramid look. 
Asymmetry is hard to fix. I try my best to fix it and use measurements down to 0.5mm if needed. Despite that precision I still cannot guarantee symmetry. 
Regards
Dr. Janjua

East Asian, female, and have pretty thick scar-prone and oily skin. Are my alarplasty expectations reasonable? (Photos)

Answers (2)

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