Hello and thanks for your question.
Alar base surgery, generally speaking, can accomplish narrowing the base of the nose with smiling and animation. The improvement you are requesting are reasonable and possible with a rhinoplasty and other possible ancillary procedures. The muscle can also be modified at the base of the nose to decrease widening with smiling.
I would highly recommend visiting a few plastic surgeons who specialize in this exacting and artistic procedure. In our office we provide patients with a personalized, individualized and complementary consultation to address these similar issues.
Triple Board Certified Plastic Surgeon
A modified weir excision could narrow your nostril flair. The cost would be $2,800 for the surgery and operating room.
Alar base reduction is a good way to decrease the width of the nostrils that flare with smiling. However, there are a few different issues that may affect your appearance and your concerns. Please consult with a board certified specialist who can assist you with achieving the results you seek. 3-dimensional computer imaging can help you visualize what you may look like afterwards and serve as an important communication tool with your surgeon.
I would have to agree with Dr. Cheng. Your nostrils do appear flared but this is also as a result of the positioning of the cartilages under the skin. Your nostrils appear notched on your side view and this is caused by the position of the cartilages. If they are repositioned, the flaring will also be less evident. You would still benefit from narrowing of the nostrils via a sill reduction and possible alarplasty. Consult with a surgeon who performs many revision surgeries each year so you can get the best opinion.
At rest I think your nose would be helped by nostril sill reduction/alarplasty and an alar rim graft on the side where your ala is notched or elevated (in the photo it's the right side of your face). Widening of the nostrils with smiling is natural and will still occur. Good luck!
Jon A Perlman MD FACS
Certified, American Board of Plastic Surgery
Extreme Makeover Surgeon ABC TV
Best of Los Angeles Award 2015, 2016
Beverly Hills, Ca
Hello,I actually think that Weir incisions/alar reduction is not the best course of action for you. I believe your lower lateral cartilages are positioned more vertically, resulting in the shape of your ala and nasal tip. Of course, you had a previous rhinoplasty, but I would ask the previous rhinoplasty surgeon if he would reposition your lower lateral cartilages at a more horizontal position. I believe this is the key for you. Best of luck!
Your nostrils also flare at rest. You may benefit from a Weir excision. This is a simple office procedure done under local.
An alar-plasty procedure can accomplish narrowing the width of the nostrils at rest, not upon animation. During the same procedure, the muscle attachments to the base of the nostrils can also be released which helps with dynamic widening when smiling.