Tip Rhinoplasty: normal procedure to taper the width of the nostrils to match the refined tip? (photos)

Question

During tip rhinoplasty is it normal procedure to taper the width of the nostrils to match the refined tip? Or is that a separate surgery? If they are two separate surgeries, which would you recommend for me? I am having surgery done on my turbinates at some point and figured it would save money to get the cosmetic portion done simultaneously.

Toby Mayer, MD · Answer

Rhinoplasty with refinement of the bulbous tip and narrowing of the alar base  are done at the same time so that the base does not look too wide after tip refinement. This can be done at the same time as the turbinates.

Anand G. Shah, MD · Answer

Dear Lucy:  preference is for all tip interventions to be performed in one setting.  If you like, please follow the link below.  The article on Nasal Analysis contains many diagrams that you may find helpful.  This may help guide your conversation with your surgeon.Hope this is helpful.  Best wishes.

Vasdev Rai, MD · Answer

Tip rhinoplasty encompasses both aspects mentioned by you.  I do not recommend combining functional operation with cosmetic operation.  Different surgeon skill sets are needed for each. For a good result approach them for what they are.  Be willing to pay for cosmetic part and see a surgeon who is good at cosmetic part.Nobody will see your turbinates. Everybody will see your beautifull nose.

William Marshall Guy, MD · Answer

Hello Lucy1985,With regards to rhinoplasty there are my ways to refine the tip.  This is best assessed at the time of your consultation to determine which would provide the most benefit both aesthetically but also maintaining your ability to breathe.  For the base of your nose, it can be narrowed at the same time if needed.  For the ideal nose, if you drop a line straight down from the inside corner of your eyes then no part of your nose should fall outside of this line.  It is hard to say based on the photos if you would need this as the views it is best seen on is the one from below and then from the front but your eyes are covered.  If it does need narrowing, this is when an alar base narrowing procedure (Weir incision) is performed.  The need for this would be known at the time of the tip rhinoplasty.   If need be, it can be done at a separate time in the office but it would be much more comfortable for you to just have it all done at the same time in the operating room.  For your planned surgery, it is rare to have only a turbinate procedure performed.  Usually it is part of another procedure like a septoplasty.  If medically indicated, it would be helpful from your pocket book to add the cosmetic procedures on because a portion of the facility and anesthesia fee would already be covered by the insurance covered part of the surgery.I hope this helps and good luck.

William Portuese, MD · Answer

Turbinate surgery is performed on the internal portion of the nose  to improve airflow through it. The turbinate surgery will have no bearing on the cosmetic appearance of the nose. An alar plasty simply narrows wide nostrils in relation to the rest of the nose. A tip rhinoplasty accomplishes making adjustments and narrowing the tip to balance with the bridge line. There are multiple ways of accomplishing a tip rhinoplasty, which is best discussed at the time of the consultation.

Stephen Weber MD, FACS · Answer

Ideally, all changes to your nose should be created during one procedure. Wide nostrils can be narrowed at the same time as tip plasty and an airway surgery. It can also be performed in office relatively easily but there's no reason to separate the procedures. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Tip Rhinoplasty: normal procedure to taper the width of the nostrils to match the refined tip? (photos)

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