Is it possible to place a graft to fix nostril flare? (photos)

Question

Had a primary rhinoplasty that left my nostrils looking large, too much space between my lip and nose and my bridge too small. I would like to change the shape of my nostril. Is this possible?

Miguel Mota, MD · Answer

Excellent question. Your nostrils seem to curve upwards. This can be corrected with cartilage graft. Lateral coral tensioning with articulated alar rim graft should increase alar stability and enhance the alar rim contour.

Best of luck,
Dr. Miguel Mota

Best of luck,
Dr. Miguel Mota

Jacob Tower, MD · Answer

Hello, hope you are well. Your photos demonstrate alar retraction from over-resection of cartilage. My guess would be that it causes not only an unnatural appearance, but functional problems as well. In my practice this is corrected with excision/lysis of scar tissue that causes the retraction and autologous or homologous rib cartilage grafting. The cartilage grafts are used to reconstruct the dorsum and lower lateral cartilages, and lower the alar rims.
Best,Dr. Tower

Gerald Minniti, MD, FACS · Answer

Your high alar arch is due to the high position of the lateral part of the tip cartilages, which was caused by a combination of very vertically oriented cartilage (prior to surgery) and cartilage removal at the time of surgery. The remedy is a revision surgery that repositions the lateral tips of the cartilage downward towards the alar-cheek groove. Once this is done, the surgeon can assess the results at that time and determine if a composite graft is necessary (skin and cartilage sliver taken from the back of the ear). This should be performed by a surgeon expert in revision rhinoplasty.

Tanveer Janjua, MD · Answer

Alarplasty does not work well for alar notching that can happen postop from a rhinoplasty. Alar grafting from ear cartilage is the solution. 
Regards
Dr. J

Ronald J. Edelson, MD · Answer

You also have a hanging columella which is contributing to the look. That is easy to fix and simpler than using an alar graft

William Portuese, MD · Answer

You have a combination of alar retraction, a hanging columella, and A mild polybeak. All these can be addressed with a closed rhinoplasty approach with all the incisions placed on the inside of the nose. That alar retraction is best treated with the composite graft harvested from the ear.