What Is The Best Method Of Nostril Narrowing For My Rhinoplasty?

Q:  Dr. Eppley, I am a 35 year African-American woman who is seeking to have a rhinoplasty to make some desired changes in the shape of my nose. Building up the bridge and lifting my tip and making it a little more narrow seems to be a standard rhinoplasty changes to my type of nose. I also want my wide nostrils narrowed but there seems to be different ways to do it. Some plastic surgeons place incisions on the inside of the nose and other place them on the outside. While I don’t want more scar than I need, I do want to see a very visible difference in the width and size of my nostrils? What do you recommend for nostril narrowing?

A: To do nostril narrowing, some nostril skin has to be removed. Whether nostril narrowing is done by incisions on the inside your nose or out is a matter of the extent of the incisions and their locations. Internal nostril narrowing incisions cut through and place scars on the skin of the nostril sill. It does create an external scar but it is very small and vertical in nature. By removing a vertical wedge of sill skin it pulls in the base of the nostril by the exact amount of sill skin removed. (usually around 5mms or so). An external nostril narrowing approach uses a similar vertical sill excision but extends it out to involve a horizontal resection of the side of the nostril as well. It is more effective at changing the width and shape of the nostril but does so with a longer scar that lies in the groove at the alar-cheek-upper lip junction. While poor scarring is possible, if done well the scar is well hidden and not visible.

Either nostril narrowing technique can be a very useful adjunct to the final rhinoplasty result. Which technique is better for you depends on the size and shape of your nostrils and how much of a change is needed.

Dr. Barry Eppley

Indianapolis, Indiana