What kind of nose surgery do I need to make my nostrils (or sides of my nose) much thinner?

Posted on January 7, 2017 by Donald B. Yoo, M.D.

Q: I don’t have a HUGE problem with my entire nose (such as the bridge etc.), but it really bothers me whenever I smile and my nose suddenly looks so much wider. I realize that it’s natural for that to happen, especially for an ethnic nose but I don’t want it to be so WIDE. I just want the sides of my nose to be a lot thinner and compliment my entire face. And I’m not really liking the idea of an open rhinoplasty, would it be possible if it were closed?

A: Alar base modification is an effective way to reduce the flare and/or width of the nostrils.  Showing us a base view (photo from bottom up looking up into your nostrils) is the best view to evaluate your nostrils.  Excess width can be reduced with sill incisions, excess flare with Weir incisions, and excess flare + width addressed with a combined Weir+sill incision.

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Will my rib cartilage become weaker after rib-harvesting rhinoplasty?

Posted on January 7, 2017 by Donald B. Yoo, M.D.

Q: Hi, I am a 19-year-old Asian with very thick skin. I have had multiple consultations, and almost all the doctors said that rib cartilage is the only option to augment my nose bridge. But I am really concerned with the donor site. Will rib-harvesting procedure affect the function of my rib? Will my rib be more likely to break? The procedure sounds a bit scary. Please explain it to me. Thanks a lot!

A: A small portion of the cartilaginous portion of the rib is taken (for my patients usually 4 cm from the right 6th rib).  You will not have any untoward effects in terms of health or function, and this is well tolerated even in my patients who are professional boxers and mixed-martial artists.  The biggest downside to have rib cartilage harvested is a thin 2 cm scar, which will be present in the crease under your right breast.

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Will my nose bridge grow taller as I grow?

Posted on December 11, 2016 by Donald B. Yoo, M.D.

Q: I’m 14 years old and I’m Asian. I understand Asians have pretty flat noses. I was wondering if our nose bridges grow taller or if they stays the same.

A: Your nose may change in appearance if you have not yet reached your full height.  However, if you have already had your major growth spurt than it is unlikely to change significantly moving forward.

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Revision rhinoplasty – is more definition achievable between the tip and nasal wings?

Posted on December 11, 2016 by Donald B. Yoo, M.D.

Q: I had a rhinoplasty (narrowed tip, increased projection with ear cartilage), but am still a bit unhappy about the bulkiness of my nose. I have super thick skin, so I was wondering if it was even possible to be able to achieve definition between the nasal tip and the wings of my nose? I’m not sure if it makes sense, but my nose looks quite defined in the dark, but otherwise can look extremely thick and wide in normal light.

A: Especially when seeking maximal tip refinement during Asian rhinoplasty in patients with thick skin, sometimes additional structural support is needed to achieve the projection and definition necessary to get the most refinement.

It would be possible to achieve further refinement with rib cartilage as opposed to the septal cartilage and ear cartilage, which was used for your primary surgery.  Your nose will continue to change as it heals, so it is important to allow full healing before considering revision surgery.

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If my nose is lifted up – will the nostrils get smaller or it is separate procedures. My priority is fixing the nostrils.

Posted on December 10, 2016 by Donald B. Yoo, M.D.

Q: My nostrils are big and the annoying thing is they get bigger when I talk or laugh. If this is my biggest issue – can I fix it without putting a filler to my nose – It is great to have a taller nose, but it is not my priority. Also, if I can get my nostrils smaller – later on, If I want to lift up my nose, will it still be possible?Thanks.

A: Projecting the tip of your nose (making your tip taller) will reduce the flare of your nostrils but not significantly reduce the width.  Alar base reduction using incisions around your nostrils will be necessary to significantly reduce both the width and the flare of your nostrils.

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I’m Desperately Wanting to Have Two Operations for Rhinoplasty and Buccal Fat Pad Removal on Both Sides?

Posted on December 1, 2016 by Donald B. Yoo, M.D.

Q: I had a stroke last year in Jan (I’m 40 now) & have been on Plavix ever since. I know it’s very risky for people to have any operation whilst on Plavix. Then 2 months ago, I had my gall bladder removed & only the snr surgeon would operate (another wouldn’t touch the operation due to me being on Plavix). During my surgery I needed a blood transfusion and I also needed to be in hosp. for a week and half rather than just overnight due to the excessive bleeding. So can you please give me advice on this?

A: It’s difficult to recommend elective cosmetic surgery when you are on long-term anticoagulation that probably should not be discontinued.  While the risk of bleeding for rhinoplasty and buccal fat removal is not likely to put your health in jeopardy, the increased bleeding is likely to adversely affect your results.

You may consider looking into other options with a much lower chance of bleeding complications to improve your appearance (i.e. Botox/fillers/lasers).

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Is it alright if I have one cigarette each day after having rhinoplasty done two weeks ago?

Posted on December 1, 2016 by Donald B. Yoo, M.D.

Q: I’m seventeen years old & had rhinoplasty done two weeks ago. My doctor took a bump off my nose since my nose was broken for eleven years & I had breathing problems. I have dissolvable stitches on the inside of my nose & on the right side of my head just above my right ear. My doctor said I’m healthy but I’ve been craving to have a cigarette for a long time now. So is it alright for me to have a cigarette a day or once every now & then since it’s been two weeks after having my rhinoplasty done?

A: After rhinoplasty, the blood supply and lymphatics of your nose is very sensitive and can easily be compromised. Smoking and nicotine will hurt the blood supply and circulation of your nose, which can result in poor healing. Touch base with your surgeon about when is a safe time to resume smoking. I typically instruct my patients to wait 6 weeks after surgery.

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Bad scar after rhinoplasty?

Posted on December 1, 2016 by Donald B. Yoo, M.D.

Q: I had an open rhinoplasty 14 months ago. I have a terrible scar. (I have no history of bad scarring and usually heal well). My nose has various other issues as well, and I plan on having a revision in two months with a different surgeon. I was wondering if this scar can be revised during surgery, or if it will only become worse with a revision surgery since the doc has to use my old scar? I plan on asking my surgeon this as well, obviously, but I just wanted other opinions. Thank you! 🙂

A: During your revision rhinoplasty your surgeon can perform a scar revision by excising the old scar. With a meticulous, tension-free closure the appearance of the scar should improve.

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Korea Rhinoplasty. This morning, I cleaned my nostrils with a q-tip and these 2 plastic pieces fell out from my nose.

Posted on November 20, 2016 by Donald B. Yoo, M.D.

Q: It’s been 8 months since I got my nose done in Korea, but this morning I cleaned my nostrils with a Q-tip and these 2 plastic pieces fell out from my nose. I’m really freaked out because I don’t know what it is. Please help

A: The best course of action is to touch base with your surgeon to determine how best to care for your nose.  Another option would be to seek in-person examination from a rhinoplasty specialist to ensure your nose is healing as it should.

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Asian ethnicity but given a Caucasian nose post op. Prosthetic looking nose, tip looks like a ball. What should I do?

Posted on November 20, 2016 by Donald B. Yoo, M.D.

Q: I’m 10 days post op. I am Asian but live in another country. I had rhino and fat transfer to chin. Yesterday, splint was removed. I was shocked to see a Caucasian nose on my face. Nose tip looks like a clown’s nose, my nostrils too high (pig-like) bridge too elevated-looks like prosthetics. Does the nose tip swell terribly and is at its worst on the first 2 weeks? Will it get slimmer on week 3? Will the nostril drop? Is Asian skin more thick? Will the results start to show 3rd month despite this?

A: This early in your recovery (less than 2 weeks) it is common for the tip of the nose to look like a ball due to all of the swelling.  Asian skin certainly is thicker and does swell more than other ethnicities.  Your nose will continue to change in appearance, and should improve, as it continues to heal and edema resolves.

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