Would an alarplasty or tip plasty be enough to make my Asian nose slimmer and more defined? (Photo)

Question

I'm not so concerned about a high nose bridge. It's just that the tip of my nose is so large, it swallows up my face, especially when I smile. It's also pretty wide and flat; in some photos it's like I have no nose and the whole thing is flat until my nostrils. I'd like it to be a bit more defined and feminine. I'd like a minimally invasive procedure, so is alarplasty or tip plasty enough to improve my nose? What procedures can be done to make my nose fit better with my face?

Evan Ransom, MD, FACS · Answer

Thank you for the question and your photos. Asian rhinoplasty typically includes treatment of the dorsum (bridge) of the nose, narrowing of the tip, and decrease in the thickness or width of the alar subunits (wings of the nose). In your case, the bridge is actually in a good position. So, narrowing the tip cartilages, adding some grafts for increased projection, and reducing the alar thickness would be a great plan.

Jonathan Kulbersh, MD · Answer

It is common for Asians to request more definition in the tip of the nose and a narrowing of the base of the nose.  In reviewing your pictures, I agree that you have great height to your dorsum.  I would not suggest further augmentation of this area.In regards to your tip, I believe some modifications to this area would help bring you nose in proportion to the face.  The width of the nostrils would benefit from a reduction or an alarplasty.  This would require incisions in the crease where the nostrils meet the cheek.In regards to your tip, I would suggest increasing the definition in this area.  This is achieved by using a multitude of techniques including:1)  Cartilage Grafting2)  Cartilage re-orientation3)  Cartilage reshapingI hope this helps.

Ronald J. Edelson, MD · Answer

I think you are a good candidate for both a tip plasty and alar reduction.  I also agree with you that trying to augment the nasal bridge would not be a good idea.  It's hard to do that and get it to look natural.

Donald B. Yoo, MD, FACS · Answer

Since your concern is primarily your tip, it is possible to reduce the width and bulbosity of the tip of your nose without altering the appearance of  your bridge.  The width and flare of your nostrils can be addressed as well with alar base modifcation.  The proportion of the width of the tip and the width of the nostrils is very important.  If the nostril width is reduced without reducing the width of the tip, the tip will look even more bulbous and wide in comparison.

Steve Laverson, MD, FACS · Answer

YES, well done alar base resection and tip rhinoplasty would produce a nice result, based on your submitted information.  Can always raise and narrow top of nose (dorsum) later if desired.

Toby Mayer, MD · Answer

For 35 years I've done Asian rhinoplasty and find that when the tip of the Ala are refined and narrowed that the bridge then looks even wider. Also I cannot tell if you need a radix graft from the photos. See a very experienced rhinoplasty surgeon Who does natural looking noses for the best results.

Kimberly Lee, MD · Answer

Narrowing the nostrils and refining the nasal tip are common requests from Asian patients seeking to enhance their appearance.  Asian patients are particularly bothered by the flaring out of their nostrils with smiling.  Alar base reduction is one way to address that concern and can usually be done under local anesthesia. However, the best recommendation is to consult with a board certified specialist in rhinoplasty who can assist you with achieving the results you seek.  3-dimensional computer imaging can help you visualize what you may look like afterwards.

Andrew Kornstein, MD, FACS · Answer

Yes, based on your photos, I think a tip plasty(cartilage graft) and alar plasty would significantly improve your nasal aesthetics. You may also require some thinning of the middle vault. That is a "operating room" decision, balancing the upper and lower nose.Hope this helps

William Portuese, MD · Answer

An alar plasty would be the least minimally invasive procedure to narrow the wide nose. An alar plasty involves removing a wedge of skin at the base of the nostrils to narrow them. This procedure can be performed under local anesthesia as an outpatient procedure.

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for the photos and question and though a full examination is needed a tipplasty in association with an alar base resection may give you the desired result.  Digital photography prior to surgery might show you what can and cannot be accomplished Dr Corbin

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