Combined Wedge and Sill Excision - Will It Be Able to Make a Significant Difference to my Nose? (photo)

Question

The biggest issue I have w my nose is that it's too wide.The width extends beyond the distance btw eyes (almost the same width as my lips!). I've read that combined excision can change both size of nostrils and curvature of the nose. I would like to know if this combined alarplasty will be able to successfully 'tuck in'/streamline my nose into the space btw my eyes? Also, what effect will alarplasty have on the tip? (I tried pinching the base of nose together n actually liked the result)

Donald B. Yoo, MD, FACS · Answer

While alar base modification can change the width, shape and flare of the nostrils, it will not have an effect on the tip defining points of the nose.  I'm skeptical that the photo you found on the internet represents only an alar base modification, as the tip appears to have been worked on as well.

	Alar base modification will be able to successfully "tuck in" and streamline your nose, but will not have any effect on the refinement of your tip.  In fact, it may actually accentuate the bulbosity of the tip if the tip is not addressed at the time of alar base modification.

Darryl J. Blinski, MD · Answer

It is possible but you must realize there are NO guarantees and you might need multiple minor operations. Plus potential scarring must be considered.

Steven Wallach, MD · Answer

An alar base procedure can  treat flaring and width. It will not refine the tip, that requires a tip plasty.

Richard W. Fleming, MD (retired) · Answer

After reviewing the pictures you submitted I think your will have an excellent result narrowing the base of your nose and decreasing your nostril flaring. I may change my mind after examining you but I don't think your tip needs to be changed.

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Hi,

That would be my patient that you referenced. She had a full rhinoplasty, with intra- nasal sill reduction. You can have a 2 staged procedure. I would start with an intra-sill reduction and if you still want more reduction, an alar wedge can be considered.

Best.

Dr.S.

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