Q: Dr. Eppley, I’m interested in a rhinoplasty procedure where the nostrils would be thinned out. Not brought closer to the center but actually having each nostril thinned out. However I can’t find any literature or examples on the Internet (I remember reading about it years ago though). Is this a thing and can it be done?

A: You may have trouble finding such a rhinoplasty procedure (nostril thinning) because it is very rarely done. That does not mean it can not be done just that one has to consider the aesthetic tradeoffs very carefully. True nostril thinning (not nostril narrowing or base width reduction) is done by excising skin right along the nostril rims. While this can thin the nostrils it will leave a fine line scar and may also create some increased columellar show in the side view. (alar rim retraction) This used to not be an uncommon procedure in cleft rhinoplasty. Thus a patient has to be selected very carefully for it so one does not simply trade off one nostril problem for a new set of nostril problems that may be worse than what one had initially. Scars along the edge of the nostril rim do not heal as favorably as other nasal locations.

Dr. Barry Eppley
Indianapolis, Indiana