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

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.