Can a surgeon make my nose thinner during nasal valve repair so that my nose doesn't get any wider from the grafts?

This is a great insight. If you have a wide nose it is certainly concerning that adding additional tissue as supportive grafts could make the nose wider. I regularly worry about this and we have found that by placing the grafts into the precise spots needed for support, along with thinning areas of thick skin and other tissues where necessary, we can provide the support needed without materially widening the nose, and in fact, helping the nose to look thinner while still functioning better.

Hello and thank you for your question. It really depends on your individual anatomy. Most likely your nose can be thinned while supporting the internal nasal valve to maintain a good airway. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

This is a very valid concern, especially since you already have a naturally wide nose and thick skin. The good news is that nasal valve repair with grafts (such as spreader or batten grafts) and septoplasty are often performed as part of a broader procedure called septorhinoplasty — which combines functional correction with aesthetic refinement.
With septorhinoplasty, it is indeed possible to:
Improve breathing by repairing the valve and correcting the deviated septum
At the same time, refine the nasal structure, including narrowing the bridge, reducing width, or adjusting tip definition — even in patients with thick skin
An experienced surgeon can carefully place the necessary grafts to support the internal valve without significantly widening the external appearance. In some cases, camouflage or shaping techniques are used in combination with grafting to avoid additional bulk or asymmetry.
If aesthetic refinement is important to you, be sure to discuss this clearly during your consultation. Planning both functional and cosmetic goals together is the best way to ensure a satisfying outcome.
I hope this helps clarify your options. A consultation with a facial plastic surgeon experienced in complex septorhinoplasty would be beneficial.
— Güray Yeşiladalı, MD