Q: Dr. Eppley, I want to get a rhinoplasty with you. I want to ask first though is it possible to change the nostril shape only? I want to show more of an upturned nose but I don’t want to make my nose length shorter. I just want my nostrils to have the more open look from the side. Can anything be done to make the nostrils from this closed in first pic to open in the second pic.My nose is same as first pic and does not show much nostril from the side. I want my nostrils to look like the bottom picture.I not want any different in my nose shape but only nostrils more open from side like this. What method can be done to do this? All my thanks.

A: The answer to your rhinoplasty questions comes from understanding the anatomy of the tip of the nose and specifically that of the nostril rims. The location and shape of the nostril rims is a direct reflection of the location of the caudal edge of the lower alar cartilages. (and to some degree the thickness of the nasal tip skin as well) This is well known by how the reverse is created from what you want…a lowering of the nostril rim which is done by cartilage grafting. Thus alar rim retraction, or upward rim repositioning, can be created by a resection of a part of the caudal rim of the lower alar cartilages. This can be done through a closed approach with incisions inside the edge of he nostril rims. This would not change the shape of your nose in any other way.

Dr. Barry Eppley

Indianapolis, Indiana