“I wanted to talk today a little bit about a commonly asked question with our patients coming in for Rhinoplasty, and that is about nostril width. I have so many patients that come in, and talk about the height of the dorsum or bridge of their nose. They talk about the tip and its refinement, especially in patients that have had previous rhinoplasty surgery, and they’re coming in for revisions, which now is about 50% of my rhinoplasty practice. Many of them ask about nostril width. “Is it right? Are they too thick? Should they be changed in any way?” and the answer is very individualized, but there are certain guidelines that we can use to really ascertain whether the nostrils are the proper width for the persons face individually.
Generally speaking, if we were to drop a vertical line from the corner of the eye down straight from the face and you can do this in a photograph or I can do this on a computer and show a patient, the nostril should fall within those vertical lines that are dropped straight vertically from the inner canthus or corner of the eye.
Now there are certain variations that would change that. For example if the eyes were overly narrow. Some of these things might impact our decision about nostril width or changing nostril width, and there’s a number of ways to change nostril width, some of which I really strongly do not like and disagree with doing. The best way to manage nostril width, depending on its configuration, is to determine whether the nostril width is created by a flare of the nostril or whether they’re simply set further apart on the face than they should be and in some cases it’s both for patients. If they’re set further apart than they should be, what I’ll do is create a little flap essentially from the inside of the nose that allows the nostril to rotate inward, keeping that nice curvature of the nostril which maintains a natural look.
The other way, if we just have a flare of the nostril is through the inside of the nose. We can reduce the curvature in a technique that advances just really the lining of the nose with a small amount of tissue excision underneath the cartilage. These two techniques can be used in combination, but the key thing about nostril reduction, or what we call alar base reduction, when we’re doing rhinoplasty, is to preserve a natural curvature to the nose and have it really just touch those two vertical lines that are drop vertically from the corner of the eye.
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As always I’m glad to talk to you, Corey S. Maas MDTM on Looking your Best.
