Would an alarplasty be good to slim down this bulbous nose or just a bulbous tip procedure? (Photos)

Matthew,
Creating a smaller lower nose would involve trimming the tip cartilages and shaping the tip with sutures.  The nose will also look smaller by reducing the the width of the base of the alae.  These procedures together will allow for a more balanced look to your nose.  I would do not one without the other.

While it’s difficult to make a full recommendation without seeing you in person, it does appear you would be a good candidate for both alarplasty and a tip procedure. This approach would address the bulbous tip as well as the wide nostrils, to give you a very nice result. As long as the surgeon you are working with is both board certified and extremely experienced in rhinoplasty techniques, I would trust the recommendation you received and move forward with your procedure. 

With thick skin, an alarplasty alone can make the tip appear even wider (by narrowing the nostrils and not narrowing the tip).  So you are better off doing both the tip and alae as well as thinning of the skin.

Without in person evaluation it is very difficult to give you good analysis of problem and solution for it. There is a important fact to consider; you have thick skin on the tip of the nose and it will always limit how much refinement of the tip can be achieved. Reduction of allar base and allae should be a part of your rhinoplasty. Consultation with an experienced, board certified plastic or ENT surgeon, with good reputation in rhinoplasty, is recommended. Good luck.

An alarplasty by itself would be a perfectly satisfactory choice. Very easy to go through and can even be done awake with local anesthesia. A tip plasty would be beneficial as well but the alarplasty alone is fine if that’s all you want.

Hello and thank you for the question and sharing your photos. I believe you benefit from a rhinoplasty procedure focusing on both tip refinement and alar base reduction. My best advice is that you discuss your concerns and aesthetic goals with a board-certified plastic surgeon with extensive experience in performing rhinoplasty. I would ask to see before and after pictures of their real patients. It's important that you trust your surgeon's skills and ability to achieve the results you are looking for. In particular, pay attention to your surgeon's experience with rhinoplasty. Best,

Pejman Aflaki, M.D.

Johns Hopkins-trained double board-certified plastic surgeon

Hello and thank you for your question. Based on your photographs, you may benefit from a tip refining rhinoplasty which can be performed by trimming, suturing, and reshaping the cartilage in your lower nose. You may also benefit from an alar base reduction.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and not just a computer animation system.  You should be able to view numerous pictures of actual patients with noses similar to yours performed by your surgeon.  If you cannot find enough real before and after pictures, then consider continuing your search for a surgeon. Best wishes and good luck.


Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon
 

Hello, after seen your pics, we think that a complete closed or open  Rhinoplasty, should give us a very nice result
Look for certifed plastic  surgeon
Best wishes

Hi and welcome to our forum!From your photos, I note a rounded wide nasal tip as well as thick nasal skin. Nasal projection appears normal. One may consider an alarplasty where segments of "overgrown" upper and lower lateral cartilages are trimmed to increase nasal tip definition. The thickness of your skin may limit the amount of definition achievable to some extent.Visit a board certified plastic surgeon for in-person evaluation and discussion.Best wishes...

An alar-plasty narrows wide nostrils, and that's it. To narrow wide nasal  Tip cartilages requires suture techniques and a conservative cartilage removal. Thick skin in the tip of the nose prevents refinement. Osteotomies placed in the nasal bones are required to narrow the bridge line.