Reduction of nostrils and nose wings

Nostrils, the openings of our nose, are very often in the focus of aesthetic rhinoplasty.

Large nostrils make the tip of the nose appear bulbous and wide. Many patients prefer more delicate and almost invisible nostrils as part of the nose reduction procedure. Yet they are an important feature of a beautiful and graceful nose and should not be concealed! Therefore, the shape, the position and the size are decisive in equal measure - also for the functionality. 

The nostrils are bordered at the sides by the nose wings and in the middle by the columella. They are ideally pointed-oval in shape with a broader base to the upper lip and are almost side symmetrical. Therefore, when talking about the nostrils, you should always consider the nose wings as well. 

Nostrils may be wider or narrower, rounder or more oval, less or more visible, according to skin type and ethnic conditions.

To a large extent, the framework consists exclusively of skin and connective tissue. The lateral parts in particular are cartilage-free - an important aspect if you want to perform a corrective surgery. The wings of the nose are generally unstable in many patients due to the cartilage framework being too weak or not existent at all.

Kinks, edges or retractions are formed on the lateral surfaces and borders. Asymmetries in size often occur when the nasal septum displays a curvature or the outer nose is crooked. 

First of all, it is important to consider the function of the nostrils and nose wings, in addition to their aesthetic appeal: Since nasal breathing is carried out via the nostrils, the nostrils must be neither too small nor too unstable. We need to respect a natural limitation in the surgical modification. When we take a deep breath, we engage even the fine muscles of the nose wings to stabilize the shape. 

We can compromise the function by reducing the size - a very unpleasant circumstance that is difficult to correct and which should be avoided at all costs. 

The nostrils change their shape due to the straightening of the nasal tip, which is carried out in almost all cases. They are stretched tighter and thus become narrower. The frequently expressed concern regarding increased visibility is usually unjustified: In the case of drooping nasal tips, the nostrils are unattractively invisible and noticeable for the first time after rhinoplasty. That's unusual but true. The nostrils only manifest themselves too clearly if the nose tip is over-rotated, i.e. elevated excessively. This is how you get the famous "piggy nose". 

There is another possibility to reduce the size of the nostrils and the nose wings with almost no visible scars by targeted removal of fine strips of skin at the broad base at the entrance to the nose This allows protruding nose wings to be shifted more towards the centre giving the nose a narrower appearance.

However, the nose should not be too narrow, as it always has to be considered in the context of the overall width of the face. A broad face appears empty and artificial if the nose is too narrow. 

Last but not least, a change in the shape of the nostrils can be achieved by stabilizing the nasal wing structure with small cartilage grafts from the nasal septum to compensate for the natural weak points.

Generally, it is possible to reduce merely the nostrils under local anaesthesia.

As previously mentioned, a small strip of skin is removed from the base of the nostrils. However, this procedure is only possible in the case of a limited selection of nasal tip shapes and is more likely to be performed as a minor revision procedure after rhinoplasty has already been performed if the nostrils continue to appear too large.