The Steps to Narrow a Wide Nose During a Rhinoplasty  

When considering undergoing a rhinoplasty, the goals of the procedure must be clearly defined during the consultation and pre-operative appointments.  The goals of a rhinoplasty may be functional (improving the breathing) or aesthetic.  One common aesthetic concern of patients considering undergoing a rhinoplasty is to narrow the nose.  As a rhinoplasty expert in North Carolina, we are going to discuss the steps taken to narrow a wide nose during this blog.

Step 1 – The Consultation

During the consultation process, we listen to our patient’s concerns and goals.  During this interaction, Dr. Kulbersh can begin to identify the areas of the nose where a patient wishes to narrow the nose.  The common areas patients wish to narrow the nose are:

1)     Width of the nostrils

2)     Size of the nasal tip

3)     Width of the middle part of the nose

4)     Narrow the entire nose

Dr. Kulbersh will closely examine the nose to see areas that may improve during narrowing process.  To aid our patients expressing their wishes, Dr. Kulbersh will use imaging morphing.  This is a computer program that can morph the appearance of the nose into a different shape. , Together, Dr. Kulbersh and his patients will create a nose that will be the goal of the surgery.  After this process, Dr. Kulbersh will be able to identify the areas of the nose to narrow.

Narrowing the Tip of the Nose         

To be able to narrow the tip of the nose, a rhinoplasty specialist must first identify why the tip is wide.  Common reasons for a wide nasal tip are:

1)     Thick skin

2)     Wide nasal cartilages

3)     Mal positioned nasal cartilages

4)     Large nasal cartilages

5)     Short or a under -projected nasal tip.

The tip may be wide due to one or a few of the reasons mentioned above.  The tip can be narrowed by:

1)     Thinning the nasal skin

2)     Narrowing wide cartilage

3)     Placing the nasal cartilage in a better position

4)     Removing part of the nasal tip cartilage

5)     Projecting the nose

This can be accomplished by stiches to reshape the nasal cartilage.  Medically, this is referred to as nasal tip sutures.  Sometimes cartilage has to be added to the nose to support weak or collapsed areas of the nasal tip.  This is referred to as cartilage grafting.

Narrowing the Nostrils

The nostrils are commonly wide in patients seeking ethnic rhinoplasty.  Ideally the nostrils should be close to the same size as the space between the inner corners of your eyes.  This has some variation between different ethnic backgrounds.  If the nostrils are too wide for the face, they can be narrowed with an alar base reduction procedure.  During this procedure, an incision is made in the crease where the nostril meets the cheek.  Depending on the amount of narrowing required, different amounts of tissue is removed in this area.  This area is meticulously stitched and heals hidden in the nasal crease.

Narrowing the Middle and Upper Area of the Nose

The nose is composed of cartilage and bone.  The bottom soft part is the cartilaginous area while the hard top area is bone. If the nose is wide in the hard upper part of the nose, the nasal bones are wide.  If the bones are wide they are brought closer together to narrow the nose.  This is completed by breaking or fracturing the nasal bones.   After breaking the bones in a controlled fashion, they can be brought closer together.  The bones are broken during a rhinoplasty using a medical grade chisel.  Patients are often worried about pain for this aspect of the procedure.  We are sure the process of breaking the bones would be painful.  Fortunately, patients are asleep during this part.  When they awake from surgery, the nose is in a cast.  Broken bones in a cast do not hurt.  We find our patients have little pain associated with narrowing the nasal bones.

Projecting the Nose

If a nose is short and bulbous from a profile or side view, it will look wide from the front.  If the shortened nose from a profile is made longer, it will narrow the nose from the frontal view.

Final Step – Choosing a Rhinoplasty Surgeon for a Consultation

We recommend that patients seek a surgeon that specializes in rhinoplasty surgery.  This is commonly a facial plastic surgeon although there are general plastic surgeons that specialize in nasal surgery.  If you are interested in undergoing a rhinoplasty consultation in our office in Charlotte, North Carolina, please call (704) 842-3644 or fill out the online contact form.

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