Making the tip smaller. Any suggestions? (photos)

Does this require breaking of the nose? I am going to do an alarm base reduction but I feel my top might need some work as well . I do not want a bubbious tip

Doctor Answers 7

Do not do anything to your tip

Limit your operation to alar base reduction. Real surgery does not follow rules of computer image manipulation.  Tip surgery is likely to backfire on you in long run. It will weaken your tip support.


Dallas Plastic Surgeon
5.0 out of 5 stars 22 reviews

Alar base reduction for narrowed nostrils

An alar base reduction is only performed for wide nostrils, and involves removal of a small wedge of skin at the base of the nostrils to narrow them. The bulbous tip is addressed with a conservative cartilage removal and suture techniques applied to the lower lateral cartilages of the nasal tip.  To narrow the bridge on requires osteotomies placed in the nasal bones which requires breaking the nasal bones in a very specific location. A full set of facial photographs are required to make a full determination. For more information and many examples, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 reviews

Making the nasal tip smaller may mean refining the whole nose.

Making the tip smaller is a common request in rhinoplasty consultation. This may require different techniques for different patients, but the end goal is the same. The tip needs to blend with the rest of the nose. And the nose should be in harmony with the rest of the face. I recommend a formal consultation where your nose can be examined and standardized photographs can be taken. Many practices offer computer simulation to show potential changes and the limits of your anatomy. I use a 3D system called Vectra to show the changes at all angles, for a safe and happy discussion BEFORE going to the operating room. Safety comes first. 

Victor Chung, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Making the tip smaller. Any suggestions?

Hello Cgggg -Thanks for your question.  Unfortunately, to get the result you want on the right, you will need a complete rhinoplasty procedure.  This procedure will entail narrowing of the bridge via nasal bone fracture (osteotomies) with possible bridge autmentation, followed by nasal tip reduction and tip grafting. Your tip looks like it needs to be brought down a little before the base can be narrowed any.  Just be careful that you don't end up with airflow restrictions. This can happen if you make the nose too small.  I would recommend that you consult with a rhinoplasty specialist in your area for more information.Good luck,Dr. Shah

Manish H. Shah, MD, FACS
Denver Plastic Surgeon
4.8 out of 5 stars 47 reviews

Making the tip smaller. Any suggestions?

If this is the result you desire, you would require a complete rhinoplasty. Also, given your skin thickness a result with such a thin, refined tip might not be possible. Please consult with a rhinoplasty expert for specific advice about what is and is not possible. Allow them to image your nose to show you the results that they can realistically create. I hope this information is helpful for you.
Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Making the nasal tip smaller.

Improving the nostril width and refining the tip are frequent requests of patients wanting
nasal refinement. It is possible to improve the cosmetic appearance of the tip alone without altering the rest of the nose in some patients. Whether the optimal option in your particular situation would be a tip rhinoplasty alone or an artistically performed natural appearing full rhinoplasty would best be determined at a consultation. Either procedure can be performed with a closed or open approach.
Following the advice from a surgeon on this or any other website who proposes to tell you exactly what to do based on limited 2 dimensional photos without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of the operative procedure would not be in your best interest. I would suggest you find a plastic surgeon with extensive nasal surgery experience who is certified by the American Board of Plastic Surgery and ideally a member of the American
Society for Aesthetic Plastic Surgery (ASAPS) or a facial plastic surgeon (ENT) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla,California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews

Nasal harmony

Cggg- thanks for your question- which is common for many patients. True nasal harmony within the nose itself and for balance of the entire face often requires manipulation of the entire nasal framework and adjustment of multiple components. Based on your rendered image and what you appear to seek change for will require a comprehensive  rhinoplasty- tip, dorsum, mid vault, possibly the septum, grafting AND osteotomies (breaking or cutting the bones). And even then, your skin characteristics may not permit the outcome in your digital rendering.  Rather than choosing what specific techniques you will or will not undergo, I would suggest visiting with a board certified surgeon to itemize which improvements you are seeking. After an exam, they can then discuss what maneuvers/techniques can be executed to help achieve the result you seek.Ultimately, my recommendation would be comprehensive rhinoplasty done right the first time and not alar base reduction alone.Best wishes!

Christian L. Stallworth, MD
San Antonio Facial Plastic Surgeon
5.0 out of 5 stars 8 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.