Rhinoplasty, alar base reduction. Would I need open or closed rhino for the results I'm seeking? (Photo)

Hi, I am considering rhinoplasty. I am African American and while I would like to keep a nose that fits me ethnically, I still want rhinoplasty that would benefit my face as a whole. I feel as though my nose takes a lot of attention from my face. It's too wide and I'm not sure if a bridge would harmonize my face. I have a slender oval face with big eyes & full but small lips in width. I also don't like my profile when I smile. My nose widens a lot and droops a little. What would you suggest?

Doctor Answers 12

Alar reduction

Depending on how much change you want, that will determine the procedure to have. An alar base could be done for a subtle change if that is what you are looking for. If you are looking for more change, a rhinoplasty with cartilage grafting would be recommended to achieve a narrower tip and bridge.


Houston Facial Plastic Surgeon
4.6 out of 5 stars 112 reviews

Rhinoplasty, alar base reduction. Would I need open or closed rhino for the results I'm seeking?

Yes these changes can be made in closed fashion. There is no one nose or set of features that typifies a certain ethnicity. There is a great deal of diversity in individual noses. Find a surgeon who demonstrates vast experience in transforming many types of noses.

Kenneth Hughes, MD

Beverly Hills, CA

African American Rhinoplasty

Single dimensional images can be deceiving and I would urge caution in accepting surgical recommendations as promises. Physicians will need to examine and to talk with you about your concerns before deciding, with you, which techniques to perform.  Discuss not only the desired results but also the implied trade-offs, if any. Ask to view pre and post op photos of patients in which he/she has performed the manuevers that may be applicable to you. Ask which techniques, in the surgeon's experience, would likely help you to realize the results sought, rather than limiting him/her by  insisting on a technique from the surgeon. 

Closed Rhinoplasty

Thank you for your question and at a consultation aided by digital photography and your input, you will be able to see what changes can be accomplished with your nose.  So see some experts in your area

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 60 reviews

Open rhinoplasty candidate, some advices:

Thank you very much for the questions.
The harmony between facial parts makes us instinctively recognize the beauty... without knowing it, without defining it, just a perception that surprises and captivates us.

In this regard, After having analyzed all the info. and photos provided to us, i recommend you perform an Open Full Rhinoplasty, includding narrowing of the nasal base and nostrils, with nasal bones treatment (controled fracture) and alar + triangular nasal cartilages re-shaping.
With this procedure you get a delicate nose, better harmonize with your other facial features.

Respectfully,
Dr. Emmanuel Mallol.-

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 176 reviews

Alar base reduction and tip refinement

The african american nose has very distinct characteristics that create the typical appearance for many. There is a low dorsum, or bridge, due to widened nasal bones that produce poor definition of the profile. Additionally, there is thickened skin, widened nostrils, and poor tip definition which overall produces a widened, poorly defined nose. All of these factors need to be addressed to successfully treat a nose such as yours. It frequently involves adding some contour and definition to the dorsum, or bridge of the nose. Once the bridge or dorsum is better defined, the underlying tip structures need to be addressed and added support frequently needs to be added in the form of a columellar strut to structurally maintain the desired tip definition. I would recommend an open rhinoplasty to address your concerns as this will be the best way to add structure to the nose. Lastly, the nostrils will inevitably need to be reduced to match the overall harmony of the nose with the face. In short, your nose will look more defined on your face, and may look smaller because the nostrils and nasal structure are more narrowed and refined to fit your face.

Michael T. Somenek, MD
Washington DC Facial Plastic Surgeon
5.0 out of 5 stars 29 reviews

African American rhinoplasty

It's difficult based on the pictures submitted to give a completely detailed answer. That said, an open rhinoplasty with alar base resections and cartilage grafts would allow for a better dorsum, tip definition and more narrow alar bases. Obtain a consultation with a board certified plastic surgeon for an evaluation and discussion of surgical options.

African American rhinoplasty

It is difficult to know exactly what you need from the photos you submitted. However, based on  my prior experience, the framework of African American noses is often lacking requiring enhancement with either cartilage from the nose or ear or bone from the head. The base of the nose often requires reduction with a direct approach. The bridge of your nose should be in harmony with the tip and often both require grafting. Make sure you find someone who has experience with these issues.

Susan Kaweski, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 4 reviews

Ethnic rhinoplasty, open vs. closed

Hello Applepeachcobbler and thanks for your questions. From the photos that you've submitted I'd recommend an open rhinoplasty with an alar base reduction to reduce your nostril size and the flaring of the nostrils. You'll need cartilage grafts to address the tip as well as the bridge. "Defatting", partial cartilage removal and suture techniques will also be needed to define your tip but maintain "ethnic balance" thus preserving your ethnic identity. Seek consultation with a BCPS. Good luck. 

To your beauty and to your health

Dr B. 

Consult with a rhinoplasty specialist

Ethnic Rhinoplasty can be complicated and requires proper evaluation, discussion of options/expectations and structural nasal reshaping techniques.
Open and structural closed rhinoplasty can both meet your goals of refining your nose.  A successful rhinoplasty can be described as a nose that harmonizes with the rest of your face. 
Based on your question and pictures provided, I recommend refining your tip with structural cartilage grafting and nostril narrowing.  You could possibly benefit from nasal dorsum augmentation; however, I recommend seeking out a board certified facial plastic & reconstructive surgeon to discuss all your options and formulate a plan. 

Karan Dhir, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 48 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.