I Have Thin Nostril Rims And Weak Lower Lateral Cartilages, What Can I Do To Firm Up My Nose?

I am a black male, my ala rims are thin but they connect to medium size nose. but the structure inside the nose is not strong. When I flare my nose I can see the tip move and I can see the lateral crus move, recently I developed a small line in my tip through to my columella. My nose used to be strong but over time just got weaker, is there anyway it can be made strong and possibly aesthetically pleasing. I can breathe fine as my nose is now its just the aesthetics that have always bothered me.

Doctor Answers 6

Nostril flare indicates the position of the alar cartilages

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You have an interesting nasal base configuration that I have seen before in African-American noses and treated successfully. 

The nostrils not only arch but also flare outward like a skirt, which is because your tip cartilages run up toward the inner corners of your eyes rather than the outer corners--a normal variation that occurs in most Blacks and at least 50% of Caucasians.  This cartilage position means also that your nostrils are not as well supported  they would be if the cartilages had been closer to the rims.

In some patients whose cartilages are deforming, I have repositioned the cartilages without adding cartilage grafts. In your case, I would leave the cartilages where they are and add cartilage grafts.   I would also reduce your nostrils size conservatively.  You need some width to balance your face and upper nose, as well as your tip width.  Finally, seek out a surgeon who can do this surgery closed, which is easy, and you will not have to worry about the columellar scar, which may not be good.

Best of luck.

Nashua Plastic Surgeon

Rhinoplasty grafts for increasing support to lower nose

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To strengthen the lower part of the nostrils, additional cartilage support is required.

The most common grafts would include lateral crural strut grafts (using septal cartilage to support the lower lateral cartilage), and alar rim grafts which are very thin grafts placed at the margin of the nostrils.

Hope that helps,

-Dr. Asaria

Jamil Asaria, MD
Toronto Facial Plastic Surgeon
4.8 out of 5 stars 139 reviews

Weak Cartiages in Black Noses

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The soft (or weak) cartilages are common in Black noses. Depending on your goals the width and flare of the nostrils can be narrowed, the contour of the tip cartilages can be changed and cartilage added to the columella to increase and maintain tip projection, and alar rim grafts will refine your nose. Select a rhinoplasty surgeon who has experience with Black patients.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Structural rhinoplasty adds support to a weak nose

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Like many patients of African descent, your nose has softer, broader cartilages.  This contributes to a wide tip and hanging tip and columella.  The line you see in your columella is a shallow vertical cleft between the inner edge of your two tip cartilages.  Structural grafting in rhinoplasty can serve to add support to strenghten your nose while changing the shape.  Cartilage grafts could be used to add support to elevate the tip and columella and strengthen the lateral (side) wall of the tip.  A thin camouflage graft could be used to efface the cleft in the columella.  Depending on how you feel about your flared nostril, a reduction could reduce the prominance of the flare. 

David W. Kim, MD
Bay Area Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

Rhinoplasty for the African-American nose.

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Rhinoplasty for the African-American nose such as yours involves nostril narrowing, alar rim grafts, elevation of your hanging columella, refinement of the tip cartilages an an increase in tip projection. This needs to be done by an experienced rhinoplasty surgeon who has done many African-American noses!

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Ethnic Rhinoplasty Techniques

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Hi Ponder85,

Over time, the ligaments that hold the tip cartilages together start to loosen and cause your tip to lose support, which is likely why you are seeing more nostril flare and a greater sense of tip drop and loss of support. Ethnic rhinoplasty is aimed at increasing this tip support so that your nose will be stronger and have a more pleasing aesthetic contour over the long term. If you see a rhinoplasty surgeon with a lot of experience in Ethnic Rhinoplasty, you should expect a very successful outcome. Check out our blog article on the topic. All the best.

Jason Litner, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 52 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.