I Feel Like I Have a Pug Nose After Alar Reduction, Will It Improve in Time? (photo)

I had alar base reduction performed 5 days ago ( i know it' still early), and I'm still swollen. But I'm very concerned with the fact my nose now has an upturned appearance. It looks like the doctor pulled the edges of my nostrils too low, so now my tip is upturned. Can the swelling cause this? Or am I going to need to have my columula cut to make up the difference? Help!

Doctor Answers 5

I Feel Like I Have a Pug Nose After Alar Reduction, Will It Improve in Time?

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  Aesthetically, the nasal tip is at approximately 120 degrees and as such is over-rotated making it appear short.  The ideal angle is between 105 and 115 degrees.  The nose may drop with time, after your Rhinoplasty, and there are manipulations that can encourage downward tip rotation.  Understanding and following the proper aesthetics of facial (and nasal) beauty is paramount, IMHO, for the creation of a naturally, more attractive nose and face.  This should, IMO, be the first and foremost characteristic used to select a plastic and cosmetic surgeon to perform Rhinoplasty, Face Lifts, Eyelid Surgery or any other treatment or procedure.  

Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Alar reduction at five days

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It is so hard to tell after just five days, though the photo looks like you are off to a good start. Alar reduction alone should not cause tip rotation, so relax and let things settle.

Best of luck, peterejohnsonmd.com

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Will my pug nose improve (photos)?

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You are correct in understanding it is too early after your procedure to evaluate aesthetic factors, and probably inappropriate for other surgeons to comment on your outcome at this time.  It appears you've had rhinoplasty previous to this most recent intervention.  Small contour and proportion issues can often be corrected non-surgically.  Major changes can be accomplished surgically, but only after comprehensive review of your complaints, previous procedures, and physical examination.

Steve Laverson, MD
San Diego Plastic Surgeon
4.9 out of 5 stars 50 reviews

Patient Is Paramount In Any Form of Rhinoplasty

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At just five days after surgery, it is too early to judge the final aesthetic outcome...unless alar base reduction was the only procedure you have done. But if you have had a tip or full rhinoplasty done at the same time, which is likely, then you need six months before you should be critically analyzing the relationship between the tip of the nose and the alar bases.

Give it some time

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Just curious but was anything else done besdies the alarplasty?  It looks to me as if the alar width was only minimally reduced and that alar hooding was present prior to the procedure.  In my mind, the main thing that needs to be done is to increase the nasal tip projection and to create a more defined nasal tip. 

You should wait at least 2-3 months and then if you are not happy you should see someone very experienced with complex nasal surgery and who is skilled in the use of cartilage grafts to support and define the nose.  IN my mind there are probably less than 1000 surgeons in the US who fit this description.....a few are general plastic surgeons and the remainder are Board Certified Facial Plastic Surgeons.

S. Randolph Waldman, MD
Lexington Facial Plastic Surgeon
4.6 out of 5 stars 19 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.