Can Rhinoplasty Make My Nostrils Smaller?

Q: Dr. Eppley, I am looking for a rhinoplasty that can get my nostril size reduced. I would like to reduce how much of my nostrils you can see from a front profile ( basically bring the front of my nose down). Lastly I don’t like how you can see in my nostrils from the side profile. Does this all seem possible?

A: From a rhinoplasty standpoint, the size of one’s nostril’s is controlled by several anatomic factors. These include the length of the lower alar cartilages, the amount of caudal septal support, the angulation of the lower alar cartilages away from the dome and the width of the nostril base. When looking at your nose, the main reason you have a lot of nostril show is that the length of your nose is short making the tip of your nose rotated upwards. (which is why there is excessive nostril show in the front view) In addition, you have alar rim retraction with a bowed rather than straight alar edge. (which is why these is too much nostril show in the side view)

To increase your nasal length and decrease nostril show, your rhinoplasty must have increased structural support. This is done through cartilage grafts, harvested from the septum or ears, placed to push the tip of the nose down (septal extension graft) as well as along the edge of the lower alar cartilages. (alar rim grafts) You may also benefit from nostril narrowing as well but that can only be determined by a front view picture which you did not provide.  I have attached some imaging to show what this type of rhinoplasty can do.

Dr. Barry Eppley

Indianapolis, Indiana