How do I avoid getting the uplifted triangular shaped nostrils I see so often on westernized Asian rhinoplasties? (photos)

Asian rhinoplasty, avoiding triangular nostrils is possible if you select a very experienced surgeon who does not do this. If the cartilages r weakened too much this  causes the collapse of the Ala and therefore a triangular shape.

Nostril triangulation can occur in Asian rhinoplasty when the nasal tip maneuvers are performed to narrow the nasal tip and nostril side walls move in too much. This can be a side effect of rhinoplasty.  This can be avoided if cartilage grafts are added along the nostil rim to provide nostril support.  In situations where this has occured secondary rhinoplasty with cartilage grafting can often correct this.

Most rhinoplasties remove a rim of cartilage from the lower lateral cartilages.  This gives a nice elevation to the tip but can lead to the peaked nostrils you describe.  To avoid this, adding an alar rim graft will help correct this. 

Asian rhinoplasty is unique in that the approach to the thicker skin and soft tissue must be balance with the aesthetic concerns of the patient. The western or caucasian rhinoplasty patient presents with thinner skin, strong cartilage, and different aesthetic concerns. To keep the asian nose looking ethnic, avoiding excessive removal of the lower carilages, balancing the profile with cartilage augmentation from the septum or rib, and keeping the tip symmetric but not overly rotated is necessary. Consider consulting with a rhinoplasty with experience in Asian Rhinoplasty.

Dear AsianRhynoplasty,To avoid notched or triangular nostrils, you can place grafts along the rim of the nostrilThese grafts smooth the transition of the nostrils so that you do not get the notchingYou can raise the bridge and lower the tip with cartilage graftingDepending on your anatomy, you may need extra cartilage (such as rib) for that kind of workWhen you are ready, please see a rhinoplasty specialist who can address all of your concernsBest,Nima Shemirani

A natural looking Asian rhinoplasty should not have distracting features as you describe: an over turn tip with overly visible nostrils, abnormally shaped nostrils and alar that sits straight on the face without a nicely curved transition.A proper analysis and a combination of techniques is necessary to avoid this unnatural look.For example , care must be taken when reducing nostrils to avoid visible scars while persevering some curvature when transitioning from the alar to the cheek.The  overly rotated tip with nostril show may not be apparent early  after the rhinoplasty but occurs over time as the nose contracts. To avoid this, enough structure should be left or added to the nose when modifying the Asian nasal tip.The triangular shaped nostril  after Asian tip rhinoplasty results partly from skin contraction along the nostril rim when cartilage support of the nostrils are inadequate.We published a paper on the use of alar rim grafts to help contour the nostrils.

That is a great question. Avoid an incision in the natural alar curvature of the nose. This is what usually results in the triangular appearance that you are talking about.The incision for reduction should be on the underside of the alae. †his results in a more natural appearance and hides the scar better.

First and foremost you need to go to a very talented and experienced rhinoplasty surgeon. If you can find one who has a lot of experience with your particular ethnic group (Asian) that's even better. He or she should be able to show you books of excellent before and after results to hopefully give you confidence in the surgery. If you have weak alar cartilages that are a set up for the look you want to avoid, then your surgeon needs to take structural cartilage grafts from your ear to prevent the problem from ocuring...these grafts properly placed can help maintain the nice natural curve to the nostrils you desire