How Severe is Nostril Scarring After Revision Rhinoplasty?

Reducing the size of the nostrils is a common procedure in rhinoplasty. It involves removing extra skin where the nose meets the face, placing the incisions in natural lines to hide them. The scars usually heal well and are difficult to see when healed. It is important for all patients to realize that any skin incision will create a small scar, even if well done. As always, there is a trade between a better nostril shape and the presence of small scars.

The width of the base of your nose can be reduced. It requires a visible incision hidden along the outer crease of the nose. If the skin quality is favorable like your, then the resulting scar is hardly noticeable. There is a limit to the reduction that can be achieved and its usually less than what is desired. However that alone shouldn't stop you. I'd encourage you to continue.

Your surgeon is correct in that you will have some degree of scarring with this type of revision procedure. Usually the incisions are placed along the outer margin of the nostril where it joins the cheek. Alternatively, some incisions are placed along the nasal sill, which is the area between the columella (the column separating the two nostrils) and the outer margin of the nostril.

In still other cases, both incisions are combined. In most patients these incisions heal quite nicely and are barely visible to the naked eye. Like all scars, they are visible initially, start fading away within a few weeks and continue healing upwards of one year following surgery. This type of base reduction procedure can really help to provide a much more balanced looking nose.

Nostril size can be further reduced but you want to be conservative; once tissue has been removed, it cannot be placed back in. When too much skin has been excised, the sides of the nostrils (the alae) can appear too straightened or artificial. You want to leave a little curve so that the nostrils do not look operated upon. If the incisions that are made to reduce the nostrils are visible they can be dermabraded after about 6 weeks after surgery to make them look less visible. 

Addition reduction of the nostril size can be achieved by making incisions at the base of the nose where the outer margins of the nostrils join the face. Scarring is  usually favorable in a person like you with light skin color. I would encourage you to proceed with the revision.