Why are my nostrils notched and triangular? What causes an alar retraction?

Question

Hello! I had my first rhinoplasty over a year ago and my nostrils now look triangular from the front. Ive heard this is called notching or alar retraction. I am aware that an alar rim graft can fix this but i am more wanting clarity on what causes this. Feel free to use medical terminology and techniques, I understand them. The more detailed your answer is the better!!! Thank you for you time and help

Ronald J. Edelson, MD · Answer

Alar notching can be caused by over resection of mucosa. It can also be caused by suture placement along the rim in the apex of the nostril. I have noticed the latter occurring in a patient of my own

Selcuk Inanli, MD · Answer

Hello! Thank you for your question. Unfortunately it is not possible to make a proper evaluation without any photo of your nose. If you can provide photos from front of your face, from the side of your face and 1 meter away I would be able to make a proper evaluation. It would be more convenient to decide with face-to-face consultation. Best Regards!

Behrad Elmiyeh, MBBS, MRCS, FRCS (ORL HNS) · Answer

Thank you for your question.
During rhinoplasty if one has a prominent and bulbous nasal tip, surgeon may perform cephalic reduction of the lower lateral cartilages. If so, wound retraction as part of healing process may cause notching appearance of alar rims. Of course, without the benefit of seeing your operative notes and seeing your images one cannot tell if this was the case for you.
Best wishes

Robert Ciardullo, MD · Answer

What causes Alar notching after nasal tip surgery? surgery on the nasal tip involves incisions through the lining mucosa and cartilage of the nasal tip. This heals with the formation of scar tissue. Scar issues sometimes contracts and that contraction can cause an upward tension on the rim of the nostril which result in the notched appearance you are referring to.

Why are my nostrils notched and triangular? What causes an alar retraction?

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