I want to make my nose wider (alar base increase) again and open up the nostrils.

Question

I will go to any surgical extremeties to make my nose wider(alar base),even if I have to use forehead flap. I suffer from chronic depression since having rhinoplasty 12 years ago. In my first rhinoplasty I had Alar base reduction, made tip thinner in the nasal valve area. Lifted the nose, so now my nostrils are more visible.And my nose looks a bit shorter. Please help I want to widen the nose in alar base, and in make the nose bigger in the nasal valve area

Alejandro Nogueira, MD · Answer

Seems your nose needs a very very complex revision procedure to, essentially, perform an augmentation, lengthening or expansion rhinoplasty due to a previously too aggressive structural reduction affecting not only the nostrils, but also the nasal lenght, rotation, caudal septum, etc.All the former is feasible and treatable, requires top notch skills in structural revisions, grafting, experience, artistry and plenty of patient, however can be done in the right hands.Regarding the nostrils reconstruction... if it is required only a slight augmentation of the nostrils there are methods to reinforce them and thus expand them a bit; if the shortfall of tissue might be larger then additional fresh tissue has to be supplied by means of, first step, a composite grafting or, second step, a local or regional flap to provide better aesthetic quality tissue.The forehead flap is an option, true, but not the only one and actually not the first choice for your case; I'd rather rule it out as first instance and I'd be more thinking about some local flaps like the nasolabial flaps, turnover flaps (revolving doors) and others, but to tell you a better opinion we need to see your case.Regarding the narrowing of the nasal valve that can be fixed by structural expansion, this means additional and new cartilaginous grafting.See the link below to find cases of my own practice very similar to yours which I had the opportunity to operate successfully on, sharing a lot of common features with the technical problem you have posted.
If you wish better grounded opinion well lit, focused and standard images have to be assessed: frontal, both lateral and both oblique views, also underneath the nostrils.
Feel free to request any additional information from me.

Jeffrey H. Spiegel, MD · Answer

Sometimes we add cartilage to improve the structure. Othertimes we just move the nasal skin and that can correct the problem.  Photos would help considerably in helping to determine exactly what is best for you.

John Michael Thomassen, MD · Answer

You do not need a forehead flap for this.  In fact the treatment can be quite simple and it involves using a composite graft from the ear to add width to the alar base.

I want to make my nose wider (alar base increase) again and open up the nostrils.

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Everything you need to know about Revision Rhinoplasty

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I want to make my nose wider (alar base increase) again and open up the nostrils.

Answers (3)

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Recommended reading

Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.