Nostril Reduction

In some noses, the base is wider than it should be and a nostril reduction may be required. This occurs more commonly among Ethnic Rhinoplasty surgery such as African American rhinoplasty, Asian rhinoplasty, Hispanic/Latino rhinoplasty, or Middle Eastern/Mediterranean rhinoplasty surgery. Dr. Sam Rizk, a New York City Rhinoplasty specialist, can remove a wedge of tissue at your nostril bases and he usually does it from the inside part of the nostril, not from where the nostril attaches to the cheek. Dr. Sam Rizk feels that making a nostril reduction incision on the outside of the nostril where it connects to the cheek makes the scar visible and he prefers to hide the scar on the inside part of the nostril. The procedure is sometimes called a Weir excision. This technique can narrow your nostril bases, reduce the length of your nostril sidewalls, and make your nostrils smaller, depending on the design of the wedge excisions.

A Weir excision is performed if your nostril bases are wider than ideal (see diagram below). Ideal is difficult to define and depends on many factors, including size of face and mouth and width of nose, but an imaginary vertical line drawn from the inside border of the eye is generally used as a guide for the outside border of the nostrils. So in other words, the nostrils should lie within and not outside this imaginary vertical line. If you have an exceptionally protruding nasal tip and your tip projection is reduced surgically, the rims of your nostrils may flare and appear too large and buckle outwards and weir excisions can solve this problem. They can also be used to make oversized nostrils smaller.

The scar Dr. Sam Rizk modified for Weir excisions sits hidden on the inside of the nostrils and are almost virtually invisible. In any case, the benefit of the excision outweigh any negatives of a small scar. The diagram below shows the incision lines (in red) typically used for weir excisions.

Dr. Rizk has also innovated use of a special suture that narrows the base of the nose that goes under the skin from nostril to nostril in the area under the nose. This suture can also narrow the base of the nose and is placed from an internal incision inside the nose. Sometimes, Dr. Rizk uses this suture alone or in combination with a Weir Excision.

Dr. Rizk also looks at the size of the mouth and width of the mouth and cheeks to create a balanced face and nostril reduction is done to be in harmony with these structures. Dr. Rizk further has a technique of rotating the nostril so they don't create a pointy look at the upper part of the nostril, typical of older nostril reduction and a bad tell-tale sign of rhinoplasty. Dr. Sam Rizk's technique maintains the natural architecture and curved shape of the nostril while making them smaller.

Asymmetries in nostril size, shape or thickness can also be corrected with various nostril techniques which may involved cartilage grafts or fat removal or addition. Some nostrils are very collapsed and straight from previous rhinoplasty surgery and a revision rhinoplasty with either fat injection or a cartilage graft into the nostril can recreate the natural curvature of an attractive nostril. Poor scars from a previous nostril reduction which was unsuccessful can sometimes also be improved, depending on where the scar was placed and whether it was in a natural crease or visible.