A nostril reduction is a surgical procedure that creates better symmetry to the nose and an improved balance of the facial features. Some people with large or prominent nostrils are self-conscious of their nose and less confident in their appearance. Therefore, nostril reduction surgery is a great solution for them. Dr. Gary Linkov is a top-rated plastic surgeon in New York City who understands the intricacies of changing the appearance of the nose. City Facial Plastics, located in Manhattan, NY, offers nostril or alar base reductions to balance the nose.
What Is Nostril Reduction?
Nostril reduction involves removing tissue in strategic locations at the base of the nose to improve symmetry and narrow the nose. Rhinoplasty nostril reduction can be performed in combination with other nasal cosmetic or functional procedures, such as a rhinoplasty, or as an isolated procedure. When nostril reduction is performed as a standalone procedure, it can be done under local anesthesia in the office setting with minimal risk. It is important to remember that ethnic variations do exist in nasal aesthetics and need to be considered in nostril reduction.
When considering cosmetic improvements to the nose, attention is often focused on the nasal bridge and tip. Another part of the nose that has a profound impact on the overall aesthetics of the nose are the nostrils. The nostrils make up the majority of the base of the nose, referred to as the alar base. A nose nostril reduction, or alar base reduction, can be performed to provide refinement to the nose and to place it in better harmony with the rest of the face.
Alar Base Alterations
An alar base reduction is a less-invasive and simpler procedure than complete rhinoplasty. It is an open procedure, which means the incision is made on the outside of the nose. In most alar base and a large nostril reduction procedures, a small incision can be made on the outside crease of the nostril. A small wedge is removed on either side of the alar base to reduce a wide nose. The nostrils can be reshaped to improve the appearance. This procedure is often performed under local anesthesia, reducing the downtime after the procedure.
Who Is a Good Candidate for Nostril Reduction?
A good candidate for a nose job nostril reduction has at least one of the following characteristics, including:
- Alar flaring – lateral aspect of the ala extending significantly beyond the alar-facial groove
- Distance between ala greater than a distance between inner corners of the eyes (intercanthal distance)
- Wide nasal base
What Is the Relevant Anatomy for Nostril Reduction?
For a complete understanding of the types of nostril reduction performed by Dr. Linkov, a brief review of relevant anatomy is essential:
The alar lobule is the convexity that connects with the cheek at the alar-facial junction. The ala is composed of skin, fibrofatty fascia, and muscle (not cartilage). It helps define the lateral aspect of the nostril opening.
The alar rim connects the nasal tip lobule to the alar lobule. It is primarily composed of the lateral crura of the lower lateral cartilages. The shape and strength of this cartilage help define the nostril opening.
The columella is the central partition of the nasal base, separating the nostrils. It is composed of skin, membranous septum (cartilaginous septum further inside the nose), and the medial crura of the lower lateral cartilages. The columella defines the medial (inner) aspect of the nostril opening
The nasal sill is the inferior (lower) aspect of the nostril opening. It is a soft tissue prominence that helps define the natural border between the upper lip and the nose.
What Are the Types of Nostril Reduction?
The main types of nostril reduction surgery include:
- Alar wedge excision (modified Weir incision)
- Nasal sill excision
- V to Y advancement
These are often combined, in various configurations, to create the ideal aesthetics during your nostril reduction.
How Is Nostril Reduction Done?
Local anesthesia with or without oral sedation is used to numb the targeted area of the nose. Each procedure is performed under sterile technique.
Alar wedge excision
- Used for excessive flaring of the ala (when the nose appears wide on frontal view)
- Important not to enter into the nostril, to preserve the internal nostril border
- Goal is to avoid creating too straight of an ala, to preserve the natural curvature of the ala
Nasal sill excision
- Used for correction of the excessive flare with enlarged nasal sill width (such as when the nostril opening is wider than it is tall)
V to Y advancement
- Used when the lateral insertion of the ala is responsible for enlarged nasal base width
- The alar insertion is repositioned with a V-Y advancement
- After a wedge incision is made and the alar insertion repositioned, the stem of the “Y” is aligned with the nasolabial fold.
How to Prepare for Nostril Reduction in Manhattan, NYC?
There are a few steps you should take before your nostril reduction surgery in order to get the best results. These steps include:
- Avoiding certain medications and supplements that may thin the blood, such as:
- NSAIDs – ibuprofen (Motrin) and naproxen
- Vitamin E
- Stop smoking, as tobacco products can decrease blood flow to the skin and compromise the healing of the surgical site
- Pick up medications at the pharmacy, as your doctor will likely prescribe you certain medications, such as:
- An antibiotic
- Pain medication
- A sedative medication (optional)
- Identify an escort home, as you will need someone to accompany you home if you receive sedative medication during your nostril reduction.
What to Expect on the Day of the Procedure?
On the day of your surgery at City Facial Plastics in Manhattan’s Upper East Side, it is important not to eat or drink 2 hours before. You will take the prescribed medications in the office just before surgery. Nostril reduction rhinoplasty is performed under local anesthesia so discomfort will be minimal during your procedure. Including time spent checking in to the doctors office, marking out the surgical sites, anesthesia injections, surgery, and recovery, you should plan to be at your doctor’s office for about 3 hours.
What Is the Recovery From Nostril Reduction?
People generally recover well after nostril reduction surgery. It is normal to experience bruising and swelling, and these typically resolve within 1-2 weeks after surgery, though swelling may linger for longer. Sutures are removed at 5-7 days. Over the following weeks to months, the incision site will continue to heal and mature, and ultimately you will see final results at about 6 months-1 year postoperatively. If the scarring is unfavorable then treatments with steroids, laser, dermabrasion, or surgical revision may be needed.
What Are the Risks and Complications of Nostril Reduction?
There are risks and complications associated with nostril reduction which include:
- Poor scarring
- Poor aesthetic outcome
- Nasal obstruction (from overcorrection)
- “Q” or “tear drop” deformity – when the nasal sill is entered at its most lateral extent
- Lip malposition
Are There Alternatives to Nostril Reduction Surgery?
Nostril Reduction with Rhinoplasty
When the nasal tip is weak, the nasal base tends to widen. It may be tempting in this situation to perform nostril reduction, though the most appropriate surgery may be a septorhinoplasty procedure that strengthens the nasal tip. As the nasal tip becomes more projected, the nasal base tends to narrow which may accomplish the intended goals of a nostril reduction surgery without additional incisions. This may not only improve cosmetic appearance but may also improve nasal breathing.
Nostril Reduction with Fillers
A study published in 2016, found that hyaluronic acid-based filler could be used for the treatment goal of alar base narrowing and/or nostril shape alteration. However, this area proved to be the most difficult to treat, with only 22-45% of patients attaining satisfactory results. Therefore, fillers are not the preferred method for nostril reduction.
What Is the Cost of Nostril Reduction?
The nostril reduction cost depends on several factors. The location and expertise of the surgeon are two of the main factors that will determine how much nostril reduction will cost. For example, in New York City, the cost of nostril reduction surgery ranges from $3000 to $7,000.
Who Is the Best Nostril Reduction Surgeon in NYC?
Dr. Gary Linkov is a board-certified facial plastic surgeon in New York specializing in nasal surgery. Dr. Linkov is the best specialist with extensive experience treating all conditions of the nose. He is the Chief of Otolaryngology and Facial Plastic Surgery for the Veterans Hospital in Brooklyn, NY, where he operates on complex nasal deformities on our country’s veterans. Dr. Linkov’s private practice in UES, Manhattan focuses on cosmetic and functional rhinoplasty, as well as nostril reduction surgery.
If you have a wide nose base or prominent nostrils, an alar base reduction may be the right option for you. Contact City Facial Plastics in Midtown, Manhattan to schedule a consultation with a leading facial plastic surgeon Dr. Linkov. Discuss your nose reshaping options, including nostril reduction surgery.